CPT 01967: Neuraxial Anesthesia for Planned Vaginal Delivery
Headline: CPT code 01967 covers neuraxial anesthesia for planned vaginal delivery; widely used in obstetric anesthesia practice. Lead: CPT code 01967 denotes neuraxial anesthesia services delivered for patients undergoing planned vaginal birth and represents a common, clinically important service within peripartum care.
CPT code 01967 defines the provision of neuraxial anesthesia (epidural or spinal techniques) for a planned vaginal delivery. This code matters nationally because neuraxial analgesia is a standard component of contemporary obstetric care, affecting resource use, anesthesia staffing, and payment policies across hospitals and birthing centers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the clinical context for neuraxial anesthesia in labor, how 01967 relates to common obstetric scenarios, and links to closely related anesthesia codes used for intrapartum and cesarean care. The publication summarizes payer coverage considerations, common coding relationships, and practical billing context for claim processing and encounter documentation.
This national summary is intended for clinicians, coding and billing staff, and health policy analysts seeking a clear, focused reference on the purpose and clinical scope of CPT code 01967.
Sign up for cpt 01967 policy alerts
Get alerted when payer policies referencing 01967 are released or updated.
Billing Code Overview
CPT code 01967 describes neuraxial anesthesia services provided for a patient undergoing a planned vaginal delivery. The service involves administration and management of neuraxial anesthesia techniques such as spinal or epidural anesthesia specifically for labor and planned vaginal birth.
-
Service type: Neuraxial anesthesia for planned vaginal delivery
-
Typical site of service: Hospital labor and delivery unit or birthing center
Clinical & Coding Specifications
Clinical Context
A 28-year-old gravida 1 para 0 woman at 39 weeks gestation is admitted in active labor for a planned vaginal delivery. She requests neuraxial analgesia for labor pain management. The anesthesiology team evaluates her medical history (no coagulopathy, platelet count normal, no active infection at insertion site), obtains informed consent, and performs standard monitoring (continuous fetal monitoring, maternal pulse oximetry, noninvasive blood pressure, ECG). An epidural or combined spinal-epidural is placed in the labor and delivery unit by an anesthesiologist or a certified registered nurse anesthetist. After test dosing and confirmation of correct catheter placement, local anesthetic with or without opioid is administered to provide neuraxial anesthesia for labor and vaginal delivery. Documentation includes indication (e.g., labor pain), procedure performed (01967), level of the block, patient response, medications and doses administered, monitoring of maternal and fetal status, and any complications (hypotension, inadequate block, dural puncture). If an urgent cesarean delivery becomes necessary after neuraxial placement, conversion to surgical anesthesia is documented and may involve coding considerations distinct from 01967.
Coding Specifications
- Below are the most clinically relevant modifiers for neuraxial anesthesia in planned vaginal delivery and when each is used.
| Modifier | Description | When to Use |
|---|---|---|
AA | Anesthesia services performed personally by anesthesiologist | When the anesthesiologist personally performs the anesthesia service. |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | When the physician supervises and is responsible for more than four concurrent anesthesia cases. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | When the physician medically directs 2–4 CRNAs or anesthetists. |
QX | CRNA service: CRNA attests to medical direction by a physician | When a CRNA provides services under physician direction and the CRNA documents their attestation. |
QY | Medical direction of one CRNA by an anesthesiologist | When the anesthesiologist directs one CRNA during the case. |
QZ | CRNA service: CRNA service without medical direction by a physician | When a CRNA provides services without physician medical direction. |
62 | Two surgeons | When two surgeons are required; rarely applicable but used if an additional surgeon participates in the delivery. |
47 | Anesthesia by surgeon | When the operating surgeon provides the anesthesia (uncommon for obstetric neuraxial anesthesia). |
23 | Unusual anesthesia | When anesthesia is more complex than usual due to unusual circumstances documented in the record. |
52 | Reduced services | When neuraxial anesthesia is started but discontinued or partially performed, with reduced service documented. |
53 | Discontinued procedure | When the neuraxial procedure is attempted but discontinued for patient safety or other documented reasons. |
59 | Distinct procedural service | When another distinct procedure is performed on the same day that is separate from neuraxial anesthesia and supports separate billing. |
78 | Return to the operating room for a related procedure during the postoperative period | When a patient requires return to the OR for a complication related to the delivery/anesthesia. |
99 | Multiple modifiers — other than listed | When an uncommon or additional modifier not listed by standard anesthesia modifiers is required and documented. |
- Associated provider taxonomies commonly involved in providing neuraxial anesthesia for planned vaginal delivery:
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physicians who perform and supervise neuraxial anesthesia; typically document procedure and medical direction. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs commonly provide neuraxial anesthesia under varying models of supervision or direction. |
207V00000X | Obstetrics & Gynecology Physician | Obstetricians coordinate delivery care; may request or be present for neuraxial anesthesia placement and conversion if operative delivery required. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
O80 | Encounter for full-term uncomplicated delivery | Typical indication for neuraxial analgesia during planned vaginal delivery; reflects term spontaneous labor without complications. |
O82 | Encounter for cesarean delivery without indication | May represent situations where planned delivery becomes cesarean; relevant for conversion from neuraxial labor anesthesia to operative anesthesia (see 01968). |
O60.1 | Preterm labor with preterm delivery | Neuraxial analgesia may be used in preterm labor when vaginal delivery is anticipated; clinical considerations include fetal/neonatal status and maternal hemodynamics. |
O70.1 | Second degree perineal laceration during delivery | A common vaginal delivery complication; neuraxial anesthesia provides analgesia for repair if needed. |
O62.0 | Primary inadequate contractions | Labor dystocia may lead to prolonged labor or operative intervention; neuraxial analgesia is frequently utilized during augmentation or if eventual operative delivery is required. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01968 | Anesthesia for cesarean delivery following neuraxial anesthetic | Used when a neuraxial anesthetic initially placed for labor or vaginal delivery is converted to anesthesia for cesarean delivery; documents the intraoperative anesthetic for the cesarean. |