Wiki OB CRNA Anesthesia Coding

[kmaher]

I was wondering if anyone could help me with a few questions I have about billing and getting paid for the following scenerio's for a CRNA. An OB patient comes in and has and Epidural (01967) the same day the patient is taken to the OR for a C-Section (01968), I'm coming across deniels for the epidural stating it's inccidental to the C-section. Can anyone help with this so both get paid? Also every once in a while I get a record on my desk where an OB patient comes in has an Epidural, the same day another Epidural is performed for whatever reason. Can you bill for both Epidurals? If not how do you compensate the CRNA for the time. Some times it's two different CRNA's with in the same group doing them. Any input on these would be greatly appreciated.

 

[hgolfos]

Hey Kimberly,

There isn't an easy answer for this. It all depends on your payer. We bill in 5 different states and Medicaid in each state requires something different. Some pay a flat rate, others pay by time. We have some who will only pay if you file the C-section alone (regardless of labor epi) and others who require both codes. My best advice to you on the labor turned C-section is to find out what your payer's policy is on it.

For the second scenario, if they are doing a single intrathecal block, you can bill 62311 instead of 01967. If they are placing a cath and then dosing it later, bill 01967 with the full time, but again with certain payers you may have to cap your billed amount, check with your major payers to get their policies.

Hope this helps.

 

[kmaher]

Thanks for the info. I will get with my billing dept and have them contact our major payors to see what should be done.