Improvement
Anesthesia accuracy packet: OB review holds, supervision billing, and new safety checks
Work processed after carries this change.
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Every release and every piece of in-flight work for Medical Auto Coding. Filter by status, kind, or tag, then read the full notes below.
| Status | Kind | What changed | Version | Ticket | Date |
|---|---|---|---|---|---|
| Released | Improvement | Anesthesia accuracy packet: OB review holds, supervision billing, and new safety checks | No version | No ticket |
Work processed after carries this change.
This release closes 14 findings from a full review of the anesthesia coding stack. Several of them change what your coders will see.
Every OB case is held for review. A claim whose primary anesthesia code is obstetric (01958-01969) now carries the "OB case review" hold. This rule existed in configuration before but never fired because of a defect. If your organization does not want every OB case held, the rule can be turned off or downgraded per facility.
OB add-on codes require their primary. A claim that bills 01968 or 01969 without the 01967 labor analgesia primary is held. An add-on billed alone is a guaranteed payer rejection.
Supervision cases bill both providers. When medical direction drops to supervision (more than 4 concurrent cases), the claim now bills the physician line with modifier AD and the CRNA line with modifier QX. The CRNA line used to disappear, which underbilled the case.
Deliberate hypothermia and controlled hypotension are billed again. Codes 99116 and 99135 were blocked entirely. They now bill when the record documents the technique, and every such line carries a review flag so a coder confirms the documentation and the payer.
Post-op pain epidurals follow the NCCI rule. An epidural placed for post-op pain bills separately (with modifier 59) only when the case was done under general anesthesia. Under spinal or other anesthesia it is bundled, with the NCCI reason recorded on the claim. Placement in the OR no longer causes a silent drop.
Two new safety holds.
TEFRA settings are honored. A TEFRA attestation requirement your organization turned off is now truly excluded from evaluation. Sites with disabled requirements may see fewer "TEFRA requirements unmet" holds.
What to look out for: more held OB claims (by design), two-line supervision billing, occasional 99116/99135 lines with review flags, and the two new hold reasons in your review queues.