RhondaMB
Contributor
We are split in our office on how to properly capture this unusual delivery for us. Looking for guidance.
Patient in labor is started with an LEA, the LEA becomes insufficient or non effective, no monitoring or meds provided for about approx. an hour. The patient is taken to the OR for a C/S where the anesthesiologist uses a Spinal (SAB) for the procedure. With one of the ladies the LEA was pulled before going to the OR, while the 2nd patient had the LEA removed in the OR but both were not monitored during the time gap.
Since the anesthesia is not continuous for the Labor to C/S:
1) is 01967 & 01968 still applicable? reporting only the time for the LEA and the actual time for the C/S (time gap)
2) is 01967 & 01961 applicable, as it was not continuous?
3) do we bill just for the 01961 for the C/S time only?
some of us feel that 01967 & 01968 option is correct, reporting only the time for both the LEA and the SAB even though it is not continuous. And because the 2017 Relative Value Guide states do not report 01961 in conjunction with 01967.
some of us feel 01967 & 01961 are correct because it was not continuous.
the 3rd option was just a thrown out as a thought with no real justification.
Any help, advise or documentation to help us submit these encounters correctly would be greatly appreciated.
Thank you for your time in advance.
Patient in labor is started with an LEA, the LEA becomes insufficient or non effective, no monitoring or meds provided for about approx. an hour. The patient is taken to the OR for a C/S where the anesthesiologist uses a Spinal (SAB) for the procedure. With one of the ladies the LEA was pulled before going to the OR, while the 2nd patient had the LEA removed in the OR but both were not monitored during the time gap.
Since the anesthesia is not continuous for the Labor to C/S:
1) is 01967 & 01968 still applicable? reporting only the time for the LEA and the actual time for the C/S (time gap)
2) is 01967 & 01961 applicable, as it was not continuous?
3) do we bill just for the 01961 for the C/S time only?
some of us feel that 01967 & 01968 option is correct, reporting only the time for both the LEA and the SAB even though it is not continuous. And because the 2017 Relative Value Guide states do not report 01961 in conjunction with 01967.
some of us feel 01967 & 01961 are correct because it was not continuous.
the 3rd option was just a thrown out as a thought with no real justification.
Any help, advise or documentation to help us submit these encounters correctly would be greatly appreciated.
Thank you for your time in advance.