The autocoder codes obstetric anesthesia cases into the 01958-01969 range. This range covers labor epidurals, cesarean delivery anesthesia, and related obstetric services. Every case that lands in this range also gets a review alert, because obstetric billing carries rules that other anesthesia cases do not.

## What the autocoder produces

The autocoder reads the anesthesia record, the labor and delivery notes, and any epidural placement note. It then selects one primary obstetric anesthesia code and pairs it with the delivery procedure on the claim line.

Common outcomes:

- **Neuraxial labor analgesia.** The autocoder produces 01967 and keeps the provider who placed the epidural on that line.
- **Cesarean delivery after labor analgesia.** The autocoder produces the 01968 add-on line together with the 01967 primary line.
- **Cesarean delivery without labor analgesia.** The autocoder produces the standalone cesarean code, 01961 or 01963.
- **Cesarean hysterectomy after labor analgesia.** The autocoder can produce 01969.

## Cleanup the autocoder applies

The autocoder corrects two patterns that make obstetric claims look wrong.

1. A generic lumbar epidural code (62326 or 62327) on an obstetric case becomes 01967. The autocoder records the correction in the line rationale.
2. A vaginal delivery anesthesia code (01960) drops off the claim when a 01967 line exists on the same case. The autocoder keeps one obstetric epidural line and one cesarean line, not duplicates of each.

## Case time handling

Labor analgesia time is the part coders check most. The autocoder carries the documented neuraxial placement time and the anesthesia coverage periods onto the obstetric lines. It does not decide your payer's time-unit or flat-fee policy. Confirm the billed time against your payer rules on every obstetric case.

## Labor epidural payment modifiers

Payment modifiers on a CRNA-placed 01967 line follow your facility configuration, not a hardcoded obstetric exception.

| Configuration | Result on a CRNA-alone 01967 line |
|---|---|
| `medicalDirection.enabled` is false | The autocoder assigns the provider and adds no payment modifier. Your downstream process supplies it. |
| `medicalDirection.scenarios.crnaAlone` is `hardstop` | The autocoder adds no QZ and raises the `med_dir_crna_alone_hardstop` alert (HARDSTOP, severity 10). |
| `medicalDirection.scenarios.crnaAlone` is `bill_qz` (shipped default) | The autocoder adds QZ and raises the `med_dir_crna_alone_qz` alert (INFORMATIONAL, severity 3) as an audit trail. |

Contact your Hank representative to change this behavior.

## Obstetric alerts

- **OB case review** (`ob_case_review`, HARDSTOP, default severity 2) fires on every obstetric case in the 01958-01969 range. It asks a coder to confirm code selection, time handling, and modifiers. Read [OB Case Review Alert](/hank-codes/alerts-and-review/ob-case-review) for the full recipe.
- **OB add-on without 01967 primary** (`ob_addon_without_primary`, HARDSTOP, default severity 9) fires when the claim carries 01968 or 01969 with no 01967 line. It asks a coder to add the labor epidural line or to recode the case with a standalone cesarean code. This check always runs and is not configurable.

## How this 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.