OB anesthesia billing is even more unique than surgical anesthesia. On top of the choices groups have to bill OB anesthesia services, payors have individual claim submission requirements.
It is imperative we need complete data from our providers to maximize your reimbursement. In order to code correctly, prepare, and bill according to specific payor guidelines; please be sure you are documenting and sending to us:
- start/stop times of the epidural placement
- any monitoring start/stop times
- any face to face start/stop times and what was done during those times
- whether you were present during the actual delivery
- whether the delivery converted to a C-Section, etc.
If you do not have a specific model to follow to chart and capture these elements for billing, please let us help you.
BCBS of Kansas will be changing their requirements on January 1, 2017.
Currently, any face to face time, including the epidural placement, with an OB patient is figured and billed under the appropriate ASA code(s) and paid according to the base and time units of that code(s).
Effective January 1, BCBS is requiring the placement of the OB Epidural be billed as a fee for service injection, continuous infusion. This will be reimbursed as a flat fee regardless of any time involved. Any additional face to face time for epidural checks will be billed using the time and appropriate ASA code. Please note, if you only do and/or report the OB Epidural placement, the fee for service (non-anesthesia) code will be all that is billed and reimbursed. You must send in documentation of any time spent with the patient beyond the epidural placement, so we can bill the additional ASA code(s) when applicable.
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The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice. Specific questions about how this information affects your particular situation should be addressed to your attorney.
Editor: Philip Blann (pblann@anesthesiabilling.com).
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