In this months journal, the article on moderate sedation calculation excited the birthing center world with the possibility of being compensated for the use of Nitrous for laboring women. Currently patients have to pay out of pocket. While it’s a nominal fee, we would certainly like to cut down their out of pocket expense and also, the insurance is saving thousands by not having to pay an anesthesiologist for an epidural. Does anyone know if this coding methodology is permissible in this setting, and also, how would Nitrous (the supply) actually be billed? Since Nitrous is delivered as a mixed drug with O2, on demand it isn’t easy to measure with the devices available to outpatient facilities.