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help - places the epidural

  1. Default help - places the epidural
    Medical Coding Books
    scenario: Dr.A is on schedule from 7am to 7 pm. Dr. A got called for a c-section case. A pt needs epidural placement, but Dr. A can't do it (he's in OR for C/S), so they called another physician Dr. B. So Dr. B places the epidural, has contact with patient for 30 mins., then leaves. In the meantime, Dr. A is done with the C/S case, and nurse tells Dr. A that Dr. B placed the cath on Patient 2. now the question is: how do i bill for Dr. A & Dr. B? This is not a split case because it happened between 7am -7pm.

    most insurances asks for the contact time in this scenario Dr. B has contact time of 30 mins. And Dr A on the otherhand, after the c/s case, he did not have contact with patient 2 but he is the dr on schedule. so how would i bill this and how should documentation look like.

    confusing i know!!! pls help!!!

  2. #2
    Are Dr. A and Dr. B in the same practice? Is there any documentation by Dr. A on the anesthesia record, who d/c'd the epidural? Epidural anesthesia for vaginal delivery is not considered a continuous face-to face (which you state as contact time) service. You have a couple options depending on the documentation. You could bill 62319 (epidural placement only) or possibly bill 01967 (it appears by your question that Dr B placed epidural for vaginal delivery) with attendance time at your standard charge. We have a dedicated OB anesthesia provider each day on the OB floor. In the case of an insurance company that requires only reporting face-to-face time we still enter total time but edit the claim form to report only contact/attendance time.

    OB anesthesia documentation requirements can vary by facility guidelines. Our facility requires a minimum of hourly documentation on a labor epidural.

    Julie D, CPC
    Last edited by jdrueppel; 12-18-2008 at 08:17 AM. Reason: to clarify contact time

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