Monday, April 25, 2011

Anesthesia Coding: Convert To Units for Reporting More Minutes


While billing for code 01967, sometimes the time is over 999 minutes. In one instance, the time was 1,080 minutes. As such, may I bill the anesthesia as: 01967 (900 minutes in the units field) plus 01967 (180 minutes in the units field), or should I report it some other way?

Answer: Well, knowing how to handle multiple-digit units can be tough. Most payers that accept claims electronically can accept a maximum of three digits in the time field. By comparison, some payers that only accept paper claims and do not accept electronic claims (such as some workers comp or auto injury payers) scan in only two digits in the units field on your claim.

However this limitation shouldn't present a problem in your case.

Here's why: For 01967 (Neuraxial labor analgesia/anesthesia for planned vaginal delivery [this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor]), you should fill the units field with time units, and not minutes. Your listed units should show how many minutes is equal to one unit.

Taking in your case 15 minutes equals one time unit, 900 minutes is equivalent to 60 time units (or 15 hours multiplied by four time units per hour). Just the same, the 180 minutes would equal 12 time units. That is a total of 72 minutes time units which will fit into your two- or three-digit field.

Bonus tip: Some insurance companies may need you to report time. If software limitations keep you from reporting the proper time rather than report 01967 twice with the time divided between two lines, you could drop the claim to paper and hand-correct it, attaching a copy of the report to validate the time.

For your information: Keep an eye on your carriers. Many cap the anesthesiologist's labor at a level provided. You can find that information in their anesthesia policies by either looking online or contacting them directly.