Labor Epidurals
Anesthesia for labor epidurals are time-based services and should be billed as total minutes.
CPT code 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.) Code may be reported as a single anesthesia service.
CPT code 01968: Cesarean delivery following failed attempt at vaginal delivery This is an add-on code and should always be reported with CPT code 01967.
CPT code 01969: Cesarean delivery followed by a cesarean hysterectomy after failed planned vaginal delivery
This is an add-on code and should always be reported with CPT code 01967.
CPT code 99140: This add-on code may be billed for labor ending in an urgent or emergency cesarean delivery with four additional units.
Note: 01967 and add-on codes 01968 and 01969 require a concurrency modifier in the first position.
Scenarios:
• For labor less than 4 hours ending in vaginal delivery : CPT code 01967
• For labor less than 4 hours ending in a cesarean delivery: CPT code 01967 and 01968
• For labor ending in an urgent or emergency cesarean delivery, CPT code 99140 may be billed with CPT code 01967 and 01968
• For labor 4 hours or more ending in a vaginal delivery: CPT code 01967 with modifier 23
• For labor 4 hours or more ending in a cesarean delivery : CPT code 01967 with modifier 23 and add on CPT code 01968
• For labor ending in an urgent or emergency cesarean delivery: CPT code 01967 with add-on code 01968 and 99140
Note: Payment for anesthesia administered by the delivering physician is included in the global maternity fee.
