Labor --> C-Section for CRNA

gost

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Forgive if this has been addressed before but I can't get the search function to work today for some reason.

The MD provides the epidural for the labor portion himself. Then he directs a CRNA during the C-Section portion. The MD bills 01967-AA and 01968-QK or QY. The question is, what does the CRNA bill? We have a debate going. One side says the CRNA bills 01968-QX. The other side says the CRNA bills 01961-QX.

To my surprise, I have been unable to find any documentation on this situation beyong how the MD should bill. Any insight would be appreciated!
 

darlenemusser

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01968-QX. The Anesthesiologist and the CRNA would bill with the same ASA codes. 01961 indicates only a C-section was performed and as indicated this is not the case.
 

cindyt

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I agree with Darlene. The RVG clearly states report 01961 only when the patient has not received any labor analgesia/anesthesia care. It also states do not report code 01961 in conjunction with 01967. This patient had a trial of labor. Therefore it would be inappropriate to bill 01961. The CRNA should be billing with the same anesthesia code as the anesthesiologist, 01968.
 

gost

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Thanks for your responses. That's the way we had always been coding this situation. Recently, an argument emerged for billing 01961 for the CRNA in this situation because the CRNAs felt that 3 units for a C-Section was not enough and since they were doing the "cesarian delivery only" as the description for 01961 reads, they should be able to bill 01961. I thought that was wrong but started to doubt myself. I just thought I would see how others were billing. Thanks again!
 

leeza6681

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01968-QX is an add on code. I have been billing 01967(no modifier, since we didn't provide the service), 01968-QX. Is this correct?
 
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