Summary & Overview
CPT 01961: Anesthesia for Cesarean Delivery Only
Headline: CPT 01961: Anesthesia for Cesarean Delivery Only — Clinical and Payer Overview
CPT 01961 represents anesthesia services provided specifically for cesarean delivery procedures. This code is important nationally because cesarean delivery is a common obstetric procedure, and accurate coding for anesthesia influences clinical documentation, billing integrity, and resource allocation across hospital settings. The code applies to anesthetic management during cesarean delivery when the anesthesia is limited to the operation itself.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find an overview of payer coverage considerations and common clinical contexts in which 01961 is used, including typical ICD-10 diagnoses associated with cesarean delivery events. The publication also outlines related CPT codes for other obstetric anesthesia scenarios to clarify code selection and sequencing for cases such as vaginal delivery, neuraxial labor analgesia, and cesarean delivery following neuraxial labor anesthesia.
This summary equips billing professionals, anesthesiologists, and hospital administrators with concise clinical context, common coding adjacencies, and the payer landscape relevant to 01961. Data not available in the input for detailed service-line benchmarking and specific payer policy language is noted where applicable. The piece is organized to provide immediate guidance on code purpose, clinical applicability, and where to look next for payer-specific rules and modifier use.
CPT Code Overview
CPT 01961 describes anesthesia for cesarean delivery only. This procedure falls under the Anesthesiology service line and is typically performed in a hospital inpatient setting, such as an operating room (Place of Service 21). The code designates the anesthesia services provided specifically for cesarean delivery procedures and is used to document and bill for anesthetic management associated with a cesarean section.
Clinical & Coding Specifications
Clinical Context
A 32-year-old gravida 2 para 1 patient at term is scheduled for a planned cesarean delivery due to a prior low transverse uterine scar. The patient is admitted to the hospital operating room (POS 21) on the day of delivery. Preoperative evaluation by the anesthesia team documents maternal vital signs, airway assessment, relevant obstetric history, and consent for neuraxial or general anesthesia. Neuraxial anesthesia (spinal or combined spinal-epidural) is typically established before the cesarean incision unless contraindicated. Intraoperative monitoring includes continuous maternal hemodynamics and fetal considerations as appropriate. Postoperative handoff is provided to the recovery or postpartum unit with anesthesia documentation of drugs, doses, technique, and any airway or hemodynamic events. The anesthesia service provided for the cesarean delivery is billed under 01961 for anesthesia for cesarean delivery only.
Coding Specifications
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Common Modifiers
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AA: Anesthesia services performed personally by an anesthesiologist. Use when the physician anesthesiologist personally provides the anesthesia care for01961. -
QK: Medical direction of two, three, or four concurrent anesthesia procedures. Use when an anesthesiologist medically directs multiple concurrent anesthesia providers and meets reporting criteria for directing 2–4 cases while01961is one of those services. -
QX: CRNA service with medical direction by a physician. Use when a Certified Registered Nurse Anesthetist furnishes the anesthesia for01961under the medical direction of a physician and the encounter meets supervision and documentation requirements. -
QY: Medical direction of one CRNA by an anesthesiologist. Use when the anesthesiologist directs one CRNA for the anesthetic for01961and documentation supports medical direction of a single CRNA. -
Provider Taxonomies
| Taxonomy Code | Specialty |
|---|---|
207L00000X | Anesthesiology Physician |
367500000X | Certified Registered Nurse Anesthetist |
207LA0401X | Pediatric Anesthesiology Physician |
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Notes on use
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Use the modifier that accurately reflects who performed or directed the anesthesia care for
01961and ensure documentation supports the choice. -
The listed taxonomies identify provider types eligible to furnish anesthesia services associated with
01961.
Related Diagnoses
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O82— Encounter for cesarean delivery without indication- Relevant because this code describes the encounter for the surgical delivery for which anesthesia is provided under
01961.
- Relevant because this code describes the encounter for the surgical delivery for which anesthesia is provided under
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O34.211— Maternal care for low transverse scar from previous cesarean delivery- Relevant because a history of prior cesarean scar commonly leads to planned repeat cesarean delivery requiring anesthesia services billed as
01961.
- Relevant because a history of prior cesarean scar commonly leads to planned repeat cesarean delivery requiring anesthesia services billed as
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O66.5— Failed trial of labor after previous cesarean delivery- Relevant because a failed trial of labor often results in urgent cesarean delivery where
01961is used to report the anesthesia for the cesarean procedure.
- Relevant because a failed trial of labor often results in urgent cesarean delivery where
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O75.82— Maternal exhaustion complicating labor and delivery- Relevant because maternal exhaustion may precipitate operative delivery by cesarean, necessitating anesthesia services reported with
01961.
- Relevant because maternal exhaustion may precipitate operative delivery by cesarean, necessitating anesthesia services reported with
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O80— Encounter for full-term uncomplicated delivery- Relevant as a general delivery encounter code; when a cesarean delivery occurs in a term pregnancy, anesthesia care for the cesarean is reported with
01961.
- Relevant as a general delivery encounter code; when a cesarean delivery occurs in a term pregnancy, anesthesia care for the cesarean is reported with
Related CPT Codes
| CPT Code | Description | Relationship to 01961 |
|---|---|---|
01960 | Anesthesia for vaginal delivery only | Alternative anesthesia code for vaginal delivery; not used when cesarean delivery anesthesia is provided under 01961. |
01967 | Neuraxial labor analgesia/anesthesia for planned vaginal delivery | Represents neuraxial labor analgesia for planned vaginal delivery; may precede or be an alternative pathway to cesarean anesthesia depending on clinical course. |
01968 | Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia | Used when a patient who received neuraxial labor analgesia requires conversion to cesarean delivery anesthesia; commonly used instead of 01961 when labor epidural/analgesia is converted. |
01969 | Anesthesia for cesarean hysterectomy after neuraxial anesthesia | Used when cesarean delivery progresses to hysterectomy after neuraxial anesthesia; represents a more extensive intraoperative procedure relative to 01961. |
- Codes
01968and01969are commonly used together in clinical workflows where labor analgesia is already in place and the surgical plan escalates;01961is used for cesarean delivery anesthesia when neuraxial labor analgesia was not the preceding anesthetic pathway.