P016C – Maintenance of obstetrical epidural anaesthesia
OHIP Plastic Surgery Code — GENERAL PREAMBLE · Schedule of Benefits
Represents the time-based component for maintaining continuous conduction anaesthesia (epidural) during labour. Time units are calculated at a rate of 1 unit for each half-hour of time the physician is in attendance for maintenance, up to a maximum of 12 units. This service is part of a sequence of obstetrical anaesthesia services, often following the introduction of the catheter (P014C). As this service falls under the definition of general anaesthesia, the specific elements for general anaesthesia as outlined in the Schedule apply.
When to Use
- Use P016C to bill for the ongoing maintenance of an epidural catheter after the initial insertion procedure (P014C) has been completed.
- Apply this code for each half-hour block of time spent actively managing the epidural infusion and monitoring the patient's labour analgesia.
Common Pitfalls
- Claiming P016C alongside Z804 is a common rejection trigger, as these codes are mutually exclusive according to the Schedule.
- Failing to explicitly document the start and end times for the maintenance period in the chart will lead to automatic recovery during an audit.
- Attempting to add 'extra units' from the GP97 list to P016C is prohibited and will result in payment adjustments.
Billing Tips
- Ensure your claim reflects the total number of half-hour units provided, capped at a maximum of 12 units per patient per day.
- If multiple anaesthesiologists are involved in the maintenance, ensure the chart clearly delineates the specific time segments covered by each provider to support sequential billing.
No fee information available.
GP. General Preamble
GENERAL PREAMBLE
Procedure
Obstetrics, Anaesthesiologists' Services
Based upon the number of “units” of service rendered, the physician must record on the patient's permanent medical record or chart the time when the insured service started and ended. If the patient's permanent medical record or chart does not include this required information, the service is not eligible for payment.
Where P016C is claimed by more than one anaesthesiologist per patient, per day, the medical records must document that care was provided by each anaesthesiologist sequentially.
Female
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.