A patient presents to the labor and delivery department for a planned cesarean section for triplets. She is at 37 weeks gestation. She is given a continuous epidural for the delivery. What anesthesia coding is reported?

The procedure described is a planned cesarean section. According to the CPT® codebook, the correct code for anesthesia for a cesarean delivery only is 01961. This code is used for scheduled or planned cesarean sections where the patient has not been in labor. The administration of a continuous epidural is the method of anesthesia and is included in the service described by 01961. The fact that the patient is delivering triplets does not alter the selection of the CPT code, although it may be accounted for in the billing of anesthesia base units.

A. 01967, 01968: This combination is incorrect. Code 01967 is for labor analgesia for a planned vaginal delivery, and 01968 is an add-on for when that labor converts to a cesarean delivery. This scenario is a planned cesarean, not a trial of labor.
B. 01958: This code is incorrect as it reports anesthesia for an external cephalic version procedure, which is a procedure to turn a fetus from a breech position, not for the delivery itself.
C. 01967: This code is incorrect because it is specifically for neuraxial labor analgesia for a planned vaginal delivery. It is not used for a planned cesarean section.

1. American Medical Association. (2024). CPT® 2024 Professional Edition.

Reference: Anesthesia Section

Obstetrics Subsection

codes 01958-01969.

Details: The code descriptor for 01961 is "Anesthesia for cesarean delivery only." The descriptor for 01967 is "Neuraxial labor analgesia/anesthesia for planned vaginal delivery..." The instructional notes clarify that 01968 is an add-on code to be used with 01967 when a cesarean delivery follows labor analgesia. This directly supports 01961 as the correct code for a planned cesarean without labor.

2. AAPC. (2024). 2024 CPC® Study Guide.

Reference: Chapter on Anesthesia Coding

Section on Obstetric Anesthesia.

Details: The study guide delineates the specific circumstances for using obstetric anesthesia codes. It explicitly states that 01961 is used for a scheduled cesarean delivery

whereas the combination of 01967 and 01968 is reserved for situations where labor was managed with neuraxial analgesia prior to the decision for a cesarean delivery.