CPT 00810: Anesthesia for Lower Intestinal Endoscopic Procedures, Endoscope Distal to Duodenum - OpenPayer

Summary & Overview

CPT 00810: Anesthesia for Lower Intestinal Endoscopic Procedures, Endoscope Distal to Duodenum

CPT code 00810 designates anesthesia services for lower intestinal endoscopic procedures when the endoscope is introduced distal to the duodenum. This code captures anesthesia care associated with lower gastrointestinal endoscopy, including diagnostic and therapeutic colonoscopic procedures. Nationally, accurate use of this code affects billing accuracy, compliance with anesthesia reporting standards, and appropriate resource allocation for procedural sedation and anesthetic services.

Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for anesthesia during lower GI endoscopy, typical sites of service (endoscopy suites and ambulatory surgical centers), and common ICD-10 diagnoses that justify the procedure. The publication outlines billing relationships between 00810 and related procedural and sedation codes, and highlights common coding scenarios and policy considerations that influence coverage and claims processing.

This summary is intended for national audiences including anesthesiology providers, gastroenterologists, and billing professionals seeking a concise reference on use, clinical setting, and payer coverage considerations for CPT code 00810.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareCPT 00810anesthesiaendoscopygastroenterologycolonoscopic proceduresambulatory surgical centeranesthesiologyprocedural sedation

Billing Code Overview

CPT code 00810 describes anesthesia for lower intestinal endoscopic procedures with the endoscope introduced distal to the duodenum. The service type is anesthesia for endoscopic lower gastrointestinal procedures. The typical site of service is endoscopy suite or ambulatory surgical center, often performed for diagnostic or therapeutic colonoscopic procedures where anesthesia care is required.

Clinical & Coding Specifications

Clinical Context

A 62-year-old male presents to the endoscopy suite for a planned diagnostic and possible therapeutic lower intestinal endoscopic procedure. Indications include intermittent rectal bleeding and a positive fecal immunochemical test during colorectal cancer screening, with antecedent symptoms of altered bowel habits and intermittent diarrhea. The patient has a history of hypertension and is on a beta blocker; preoperative evaluation by anesthesia includes review of medications, fasting status, airway assessment, and ASA classification. Anesthesia services coded with 00810 are provided because the endoscope is introduced distal to the duodenum (colonoscopy). The anesthesia team (an anesthesiologist or CRNA) administers general endotracheal anesthesia or deep sedation as clinically indicated, manages airway and hemodynamics, and remains for induction, maintenance, and emergence. Intra-procedure, the gastroenterologist performs a diagnostic colonoscopy (45378) and may perform biopsy (45380) or polypectomy (45385) if lesions are found. If moderate sedation is provided by the gastroenterology team rather than the anesthesia team, documentation supports billing of sedation codes such as 99152 when applicable. Post-procedure, the patient is transferred to recovery with anesthesia handoff, monitored until discharge criteria are met, and given post-anesthesia instructions and follow-up as indicated.

Coding Specifications

Modifier	Description

CPT 00836: Anesthesia for Infant Lower Abdominal Hernia Repair

cpt-00840-lower-abdomen-intraperitoneal-anesthesia-laparoscopy

CPT 00840: Anesthesia for Lower Abdominal Intraperitoneal Procedures, Including Laparoscopy

00840

CPT 00840: Anesthesia for Intraperitoneal Procedures in Lower Abdomen

cpt-00860-anesthesia-extraperitoneal-lower-abdomen-urinary-tract

CPT 00860: Anesthesia for Extraperitoneal Lower Abdominal and Urinary Tract Procedures

cpt-00868-renal-transplant-anesthesia

CPT 00868: Anesthesia for Renal Transplant Surgery

cpt-00770-anesthesia-for-major-abdominal-vascular-procedure

CPT 00770: Anesthesia for Major Abdominal Vascular Procedures

00770

CPT 00770: Anesthesia for Major Abdominal Vascular Procedures

cpt-00702-anesthesia-upper-anterior-abdominal-wall-liver-biopsy

CPT 00702: Anesthesia for Upper Anterior Abdominal Wall Procedures, Including Liver Biopsy

cpt-00862-extraperitoneal-lower-abdomen-renal-anesthesia

CPT 00862: Anesthesia for Extraperitoneal Lower Abdominal and Renal Procedures

cpt-00802-panniculectomy-lower-anterior-abdominal-wall-anesthesia

CPT 00802: Anesthesia for Panniculectomy, Lower Anterior Abdominal Wall

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Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology Physician	Performs or directs anesthesia services including `00810` for lower intestinal endoscopic procedures.
`367500000X`	Certified Registered Nurse Anesthetist	Provides anesthesia administration under supervision or per local medical direction rules; relevant for billing and supervision modifiers.
`207RG0100X`	Gastroenterology Physician	Performs the colonoscopic diagnostic or therapeutic procedures (`45378`, `45380`, `45385`) while anesthesia provides airway and sedation management.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K63.5`	Polyp of colon	Colon polyps are common findings on colonoscopy and often prompt biopsy or polypectomy during the procedure for diagnosis and removal.
`K52.9`	Noninfective gastroenteritis and colitis, unspecified	Presents with abdominal pain or altered bowel habits leading to endoscopic evaluation when symptoms persist or diagnosis is unclear.
`K92.2`	Gastrointestinal hemorrhage, unspecified	Indication for urgent or diagnostic colonoscopy to identify and treat lower GI bleeding sources.
`Z12.11`	Encounter for screening for malignant neoplasm of colon	Routine colorectal cancer screening leading to screening colonoscopy; anesthesia may be provided for patient comfort.
`R19.7`	Diarrhea, unspecified	Persistent or unexplained diarrhea can be an indication for colonoscopic evaluation to identify inflammatory or structural causes.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`45378`	Colonoscopy, flexible, proximal to splenic flexure; diagnostic	Common diagnostic procedure for which anesthesia `00810` is billed when deep sedation or general anesthesia is provided and the endoscope is introduced distal to the duodenum.
`45380`	Colonoscopy with biopsy, single or multiple	Performed during the same session if lesions are visualized; anesthesia services support patient comfort and airway management during biopsy.
`45385`	Colonoscopy with removal of tumor(s), polyp(s), or other lesion(s) by snare technique	Therapeutic colonoscopic polypectomy frequently accompanies diagnostic colonoscopy; anesthesia facilitates patient immobility and safety during polypectomy.
`99152`	Moderate sedation services provided by the same physician or other qualified health care professional performing the diagnostic or therapeutic service	Used when moderate sedation is provided by the proceduralist rather than anesthesia provider; documents moderate (conscious) sedation distinct from general anesthesia services billed with `00810`.

`22`	Increased procedural services	Use when anesthesia complexity or time is significantly greater than usual and documentation supports increased work.
`59`	Distinct procedural service	Use when another distinct procedure is performed during the same session that is not ordinarily encountered with the primary procedure, and documentation supports distinctness.
`76`	Repeat procedure by same physician	Use when the same anesthesia service is repeated later the same day by the same provider.
`77`	Repeat procedure by another physician	Use when a different anesthesia clinician performs a repeated procedure the same day.
`78`	Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the postoperative period	Use if the patient requires an unplanned return to the procedure room for a related reason during the global period.
`80`	Surgeon assistant	Use when a qualified assistant at surgery (as defined by payer) participates; applicable payer-specific rules apply.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery	Use per payer policy when advanced practice clinicians serve as assistants and are recognized by the payor.
`AA`	Anesthesia services performed personally by anesthesiologist	Use when the anesthesiologist personally performs the anesthesia service.
`QK`	Medical direction of 2-4 concurrent anesthesia procedures involving qualified individuals	Use when the anesthesiologist medically directs multiple concurrent anesthetists and meets medical direction requirements.
`QY`	Medical direction of one CRNA by an anesthesiologist with medical direction criteria met	Use when anesthesiologist medically directs one CRNA and documentation meets requirements.

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