Summary & Overview
CPT 00214: Anesthesia for Intracranial Burr Hole Procedures
CPT code 00214 represents anesthesia services for intracranial procedures that involve burr holes and may include ventriculography. This code captures perioperative anesthesia for targeted intracranial access rather than broader craniotomies, and it is relevant to hospitals, surgical centers, and anesthesia practices managing neurosurgical caseloads. Nationally, accurate use of this code affects payment for complex intracranial anesthesia and supports proper clinical documentation for neurosurgical episodes.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of clinical context for burr hole and ventriculographic procedures, common coding relationships to nearby intracranial anesthesia codes, and discussion of documentation elements that typically accompany anesthesia coding for intracranial work. The publication also outlines benchmarking considerations and common payer interactions relevant to this service.
The content is organized to help billing managers, anesthesia providers, and revenue cycle staff understand where 00214 fits among related intracranial anesthesia codes, the expected clinical setting, and the types of neurosurgical procedures that generate this anesthesia code. Data not provided in the input are noted as unavailable where applicable.
Billing Code Overview
CPT code 00214 describes anesthesia services provided for intracranial procedures involving burr holes and possible ventriculography. The service type is anesthesia for intracranial surgical procedures. The typical site of service is an operating room or interventional suite where intracranial burr hole procedures and ventriculography are performed.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents with progressive headaches, focal neurologic deficits, and radiographic evidence of a chronic subdural hygroma requiring burr hole drainage and possible ventriculography for CSF pathway assessment. The neurosurgical team schedules a burr hole procedure under general anesthesia due to potential need for cerebrospinal fluid sampling and intracranial pressure control. Preoperative assessment documents relevant comorbidities, airway evaluation, and ASA physical status. The anesthesia team performs induction, endotracheal intubation, invasive monitoring as indicated, intraoperative management of ventilation, hemodynamics, and neuroanesthetic needs (e.g., blood pressure targets, avoidance of hypo- or hypercarbia). If ventriculography is required, contrast administration and imaging coordination with radiology occur intraoperatively. Postoperative transfer to post-anesthesia care unit or neurosurgical ICU includes handoff of neurologic exam, intracranial pressure concerns, and pain management plan.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the anesthesia service required substantially greater work due to complexity beyond typical intracranial burr hole anesthesia. |
23 |