Wiki CLE to C-Section over 2 DOS

[bgrover86]

I am looking for a little insight on billing an OB case that started as a CLE for planned vaginal birth just before midnight on day A, and transferred to a c-section on day B.

For example, the CLE was done @ 2230 on 11/18, and was transferred to c-section @ 0735 on 11/19. Would both 01967 and 01968 be billed on 11/18 (or on 11/19?); Would they be separated out between dates; 01967+time on DOS 11/18, and 01968+time on DOS 11/19? I believe the CLE (01967) would be billed for 11/18 and the add-on (01968) would be billed on 11/19... any thoughts would be greatly appreciated!

Thanks in advance!

 

[LisaAlonso23]

It depends on your billing system. In our billing system we do the following:

01967 with the diagnostic pointer(s)
01968 with the diagnostic pointer(s) that necessitated the c-section

The provider time is entered from the beginning of 01967 to the end of 01968.

Then, there's a field to enter the start time of the add-on code (01968). In your case, you would need to make sure it's the correct day AND time.

The fact that the day changes only means that you need to indicate the correct day & time of the start and stop times. 01967 & 01968 would be submitted on the same claim.

I hope this helps.