OB Case Review Alert

The autocoder raises the OB case review alert on every obstetric anesthesia case. The alert asks a coder to confirm the case before submission, because obstetric anesthesia carries billing rules that other anesthesia cases do not.

When it fires

The alert fires when the primary anesthesia code on the claim is an obstetric code (01958-01969). This range covers labor epidurals, cesarean delivery anesthesia, and related obstetric services. The alert fires on every case in this range. It does not mean the autocoder found an error.

Classification

Type and severity are classification data the autocoder attaches to the alert.

1. The anesthesia code matches the documented obstetric service (01958-01969).
2. Labor time handling: neuraxial placement time, total management time, and any conversion from labor analgesia to cesarean delivery anesthesia.
3. Time units or flat-fee rules for the payer, which differ widely on OB cases.
4. Modifiers and add-on codes agree with the documentation.

Configuration

Your facility configuration controls this alert through the ob_case_review processing rule. You can change its severity or disable it. Discuss suppression with your compliance lead first: with the alert off, obstetric cases follow your standard review routing only.

How this alert reaches you

What happens next depends on how your organization consumes HANK CODES. In HANK Claim Maker, a HARDSTOP alert places the claim in the review queue your administrators configured for it. Organizations that consume the coding API directly decide in their own workflow which alerts pause a claim, who reviews them, and when a claim is released.