Local infiltration and pudendal blockade are considered part of the management of labor and are included in the code 59410 for vaginal delivery.
Neuraxial analgesia (continuous epidural) is considered for payment in the following situations:
ü Fetal causes (eg, fetal distress, cord prolapses, placental abruption)
ü Maternal causes (eg, maternal cardiovascular disease, maternal respiratory disease, history of malignant hyperthermia, parturient with a high spinal cord injury, when a possible difficulty in intubation is anticipated).
ü Breech fetal presentation
ü Elective application of «forceps»
