Question: We have heard of nitrous oxide being used for labor patients. How would we code the use of nitrous oxide and what if the patient decides she wants to convert to an epidural for delivery?
Answer: N2O is used for analgesia, to reduce — not eliminate — the pain of delivery. The laboring patient will inhale the gas during a contraction, explains Cristina Wood, M.D., M.S., clinical director, obstetric anesthesia maternal fetal care unit, University of Colorado School of Medicine, Aurora, Colo.
Because the effects of inhaling the gas dissipate so quickly, N2O provides a number of advantages for the patient. The mother can — with assistance — continue to move around, she can labor in a tub and “if they have a tear, it can be used for peripartum services,” Wood says.
When coding, skip past the obstetric anesthesia codes and use unlisted code 01999 to report the administration of nitrous oxide for the purpose of anesthesia. You will also need to submit the records to receive payment.
Many patients do decide to convert to an epidural for delivery. Make sure to document that the patient requested the epidural and note the time you stopped administering gas. The epidural is reported with the appropriate neuraxial labor code and time.