Summary & Overview
CPT 01170: Anesthesia for Open Symphysis Pubis or Sacroiliac Joint Procedures
CPT code 01170 covers anesthesia services for open surgical procedures involving the symphysis pubis or sacroiliac joint, critical areas in musculoskeletal care. This code is nationally recognized and utilized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The code is most commonly billed in outpatient hospital settings, reflecting the trend toward ambulatory surgical care for these procedures.
This publication provides a comprehensive overview of CPT code 01170, including payer coverage, clinical context, and relevant benchmarks. Readers will gain insight into the scope of anesthesia services for these orthopedic procedures, understand the typical site of service, and review associated clinical diagnoses and related procedural codes. Policy updates and billing practices are also discussed, offering a clear picture of how this code fits into broader anesthesia and musculoskeletal service lines. The analysis is designed to inform stakeholders about current trends and requirements for reporting anesthesia in open pelvic and sacroiliac joint surgeries.
CPT Code Overview
CPT code 01170 is designated for anesthesia services provided during open procedures involving the symphysis pubis or sacroiliac joint. This code is used to report the administration and management of anesthesia for these specific surgical interventions. The typical site of service for procedures billed under CPT code 01170 is an outpatient hospital, classified as Place of Service 22. These procedures require specialized anesthesia care to ensure patient safety and comfort during complex musculoskeletal surgeries.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with significant pain or dysfunction related to the symphysis pubis or sacroiliac joint, often due to trauma, degenerative disease, or chronic pain syndromes. The clinical workflow involves preoperative assessment by an anesthesiologist, followed by administration of anesthesia for an open surgical procedure targeting the symphysis pubis or sacroiliac joint. The anesthesia service is coded with 01170, and the procedure is typically performed by an orthopedic or pain medicine specialist. The anesthesiologist monitors the patient throughout the surgery, ensuring safety and comfort, and may use monitored anesthesia care as indicated by modifier QS.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesiologist provides monitored anesthesia care during the procedure.P1: A normal healthy patient. Indicates the physical status of the patient undergoing anesthesia.
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Provider Taxonomies:
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