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PAP501

Continuous Epidural Analgesia


Provider Administrative Policy

Section
Physician
Policy Date
November 2007
Status/Date
Revised/April 2011
Provider Type(s)
Physician  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Continuous Epidural Analgesia

Use CPT® procedure code 01967 for labor and vaginal delivery.

Use add-on code 01968 for a cesarean delivery and add on code 01969 for a cesarean hysterectomy. Submit add on codes in addition to 01967.

Our reimbursement policy for anesthesia during labor and delivery allows base units plus time units. We cover anesthesia at 15-minute increments based on the American Society of Anesthesiologists (ASA) coding guidelines and base units. We cover neuraxial labor analgesia (CPT 01967 Continuous OB Epidural) at 15-minute increments for the first hour and 30-minute increments each subsequent hour, for a total of 17 total time units plus the five base units. This applies to the reimbursement based on actual attendance time. If there are additional time units, please submit medical records with a claim.


Policy History

Date Action Reason
April 2011 Revised Last paragraph removed
November 2010 Revised Labor and delivery codes clarified

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