Summary & Overview
CPT 01160: Anesthesia for Pelvic Procedures (Except Hip)
CPT code 01160 represents anesthesia services for procedures performed on the pelvis, excluding the hip. This code is widely used by anesthesiology providers in outpatient hospital settings to document and bill for the administration of anesthesia during pelvic surgeries. Nationally, CPT code 01160 is recognized by major commercial payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage and reimbursement for these services.
This publication provides a comprehensive overview of CPT code 01160, including payer coverage, clinical context, and relevant billing considerations. Readers will gain insight into the typical use of this code, associated service types, and the importance of accurate coding for anesthesia in pelvic procedures. The analysis also highlights common modifiers, associated taxonomies, and related ICD-10 diagnoses, offering a clear understanding of how CPT code 01160 fits within the broader landscape of anesthesiology billing and policy. Key benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements for anesthesia services in pelvic surgery. This resource is designed to support healthcare professionals, administrators, and policy analysts seeking clarity on the application and significance of CPT code 01160 in clinical practice.
CPT Code Overview
CPT code 01160 is designated for anesthesia services provided during procedures on the pelvis (except hip). This code is utilized by anesthesiology professionals to indicate the administration and management of anesthesia for pelvic surgeries that do not involve the hip. The typical site of service for procedures billed under CPT code 01160 is an outpatient hospital (Place of Service 22), reflecting its common use in ambulatory surgical settings. This code is integral to ensuring accurate billing and documentation for anesthesia care in pelvic procedures, supporting both clinical and administrative needs within the healthcare system.
Clinical & Coding Specifications
Clinical Context
A patient is scheduled for outpatient pelvic surgery, excluding hip procedures, at an outpatient hospital (Place of Service 22). The patient may present with conditions such as a deviated nasal septum, chronic sinusitis, nasal polyps, or hypertrophy of nasal turbinates, which require surgical intervention. An anesthesiologist provides anesthesia services for the procedure, ensuring patient comfort and safety throughout the operation. The clinical workflow involves preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative care in the recovery area.
Coding Specifications
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Modifier
QS: Indicates that monitored anesthesia care (MAC) was provided during the procedure. Used when the anesthesiologist is present and monitoring the patient, but not providing general anesthesia. -
Modifier
P1: Designates the patient as a normal, healthy individual with no systemic disease. Used to indicate the physical status of the patient for anesthesia risk assessment.
| Provider Taxonomy Code | Specialty Description |
|---|---|
207L00000X |