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Wiki Anesthesia 01967 - Do you cap it?

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mistysisk@jcmh.com

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Hi all,

Just wanted to get some feedback for coding the anesthesia pro fee for 01967. Our facility just took back coding from a third party and would like feedback on whether or not your facility implements a cap. They implemented an 8 hour cap but I have no idea why. I've been looking up information on this and I've come to the conclusion that it's really up to the facility. I've read a lot of about 4 hour caps. I know there are a few other options besides capping it but my executive is pretty set on doing it that way.
Could you please share any information you have on this? Thank you so much!
 
The ASA outlines four possible methodologies for billing neuraxial labor analgesia/anesthesia. One is base units plus time reported in minutes (insertion through delivery) subject to a reasonable cap. That cap will be payer driven, so you will need to see what each of your payers allow. Be sure to clarify with the payer too if there is a cap on patient contact time. For example, Capital Blue Cross in PA has a 10 time units cap with a 3 unit cap of patient contact time. Hope this helps.
 
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