Loading...

    Explore
    • Policy Monitoring
    • Live Policy Feed
    • Billing Codes
    • NPI Medicare & Medicaid
    • Healthcare Providers
    • Health Insurance Payers
    • States
    • Service Lines
    • Taxonomy Codes
    Lookup tools
    • Billing Code Lookup
    • CPT Modifier Lookup
    • Provider Taxonomy Code Lookup
    • Healthcare Provider & Facility Lookup
    • Health Insurance Payer Lookup
    • Payer Contact Directory

    Policy & Benchmark Tools

    • Prior Authorization Lookup
    • Coverage Criteria Lookup
    • Timely Filing Lookup
    • Billing Code Reimbursement Rates
    • Payer Comparison Dashboard
    • Facility Comparison Dashboard
    • All tools

    Company

    • About OpenPayer
    • Data Sources
    • Trek Health
    OpenPayerby Trek Health
    LinkedInYouTube

    © 2026 Trek Health. All rights reserved.

    OpenPayer is built and maintained by Trek Health.

    v1.0.28
    OpenPayerBilling CodesAnesthesia for Procedures on the Lower AbdomenCPT cpt-00812-anesthesia-colonoscopy-below-duodenum
    Ask Trek AI about this page

    CPT 00812: Anesthesia for Colonoscopy Accessing Intestines Below Duodenum

    CPT code 00812 describes anesthesia services provided for a patient undergoing a screening colonoscopy during which the surgeon advances an endoscope into the intestines below the duodenum; service type: anesthesia for diagnostic/therapeutic lower intestinal endoscopy; typical site of service: endoscopy suite or ambulatory surgical center where colonoscopic procedures below the duodenum are performed.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

    Customize your policy alerts

    Sign up for cpt 00812 policy alerts

    Get alerted when payer policies referencing 00812 are released or updated.

    Monitor payer policy activity

    Receive email alerts as soon as relevant payer policies are published or updated.

    Table of contents

    Progress1 / 7

    Explore openpayer tools

    • Billing CodesCPT, HCPCS, DRG & more
    • Reimbursement RatesCommercial vs. Medicare rate reports
    • ProvidersHospitals & facilities
    • PayersPlans & market footprint
    • Taxonomy CodesNUCC specialty codes
    • ModifiersCPT modifiers & usage
    • Prior AuthorizationPA policies by payer & drug
    • Timely FilingFiling deadlines by payer
    • Coverage CriteriaMedical necessity by payer
    • Payer ContactsClaims, PA & appeals contacts
    View all tools

    Clinical & Coding Specifications

    Clinical Context

    A 58-year-old patient presents for a screening colonoscopy performed under monitored anesthesia care. The procedure involves insertion of a flexible endoscope into the colon (intestines below the duodenum) to evaluate for colorectal neoplasia. Pre-procedure workflow includes pre-anesthesia assessment (ASA classification P2 for controlled hypertension), informed consent, IV sedation planning, and brief focused airway and comorbidity review. On the day of service the anesthesia provider administers sedative and analgesic medications, monitors oxygenation, ventilation, hemodynamics, and level of consciousness, and provides interventions as needed throughout the endoscopic examination and polypectomy if performed. Post-procedure recovery includes handoff to PACU staff, documentation of anesthesia medications and monitoring, and discharge instructions once recovery criteria are met. This scenario is typical for ambulatory surgical centers and hospital outpatient departments where screening colonoscopies are commonly performed.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    00810Anesthesia for lower abdominal procedures (e.g., colon, rectum)Alternative anesthesia code for procedures involving lower abdomen; may be used depending on exact procedure site and coding conventions
    00740Anesthesia for upper gastrointestinal endoscopic procedures, endoscope introduced proximal to ligament of TreitzContrasts with 00812 which is for endoscope introduced below the duodenum; used for upper endoscopy procedures
    45380Colonoscopy, flexible; diagnostic, including collection of specimen(s) by brushing or washing, when performed (separate procedure)Commonly performed procedural CPT by the gastroenterologist during the same encounter; anesthesia code 00812 corresponds to anesthesia for this procedure
    45385Colonoscopy with biopsy, single or multiplePerformed by the endoscopist during the colonoscopy; may extend anesthesia time and complexity
    45390Colonoscopy with removal of tumor(s), polypectomy by snare techniqueTherapeutic intervention frequently performed during screening colonoscopy that affects anesthesia time and monitoring

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    76Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    93Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A…- When to use: Apply modifier -93 when a synchronous, real-time, two-way patient–provider encounter is conducted entirely via audio-only (telephone or other real-time interactive audio-only…
    99Modifier 99 is a placeholder modifier used when more modifiers apply to a single procedure than the claim form or electronic field allows. The AMA classifies it under Provider Services and Ambulatory…- Use CPT modifier -99 when more modifiers apply to a single procedure line than the claim form or payer field allows (CMS/Noridian: when more than four modifiers are needed); append modifier 99 on…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    208600000XSurgery PhysicianA general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of s…
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    363A00000XPhysician AssistantA physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and…
    363LN0000XNeonatal Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
    1223D0001XPublic Health DentistryThe science and art of preventing and controlling dental diseases and promoting dental health through organized community efforts. It is that form of…
    207ZC0008XClinical Informatics (Pathology) PhysicianPhysicians who practice Clinical Informatics collaborate with other health care and information technology professionals to analyze, design, implement…
    2471C1101XCardiovascular-Interventional Technology Radiologic TechnologistA radiologic technologist who specializes in cardiovascular interventional technology.

    Related ICD-10-CM Codes

    28 rows

    ICD-10-CM CodeDescription
    C18.9Malignant neoplasm of colon, unspecified
    C19Malignant neoplasm of rectosigmoid junction
    D50.9Iron deficiency anemia, unspecified
    D64.9Anemia, unspecified
    E66.9Obesity, unspecified
    E78.5Hyperlipidemia, unspecified
    I10Essential (primary) hypertension
    I25.10Atherosclerotic heart disease of native coronary artery without angina pectoris
    K50.90Crohn's disease, unspecified, without complications
    K51.90Ulcerative colitis, unspecified, without complications

    Showing 1–10 of 28

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    7 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-00800-LOWER-ANTERIOR-ABDOMINAL-WALL-ANESTHESIA

    CPT 00800: Anesthesia for Lower Anterior Abdominal Wall Procedures

    CPT-00802-PANNICULECTOMY-LOWER-ANTERIOR-ABDOMINAL-WALL-ANESTHESIA

    CPT 00802: Anesthesia for Panniculectomy, Lower Anterior Abdominal Wall

    CPT-00811-ANESTHESIA-LOWER-INTESTINAL-ENDOSCOPY

    CPT 00811: Anesthesia for Lower Intestinal Endoscopic Procedure Pre-Duodenal

    CPT-00813-ANESTHESIA-COMBINED-UPPER-LOWER-INTESTINAL-ENDOSCOPY

    CPT 00813: Anesthesia for Combined Upper and Lower Intestinal Endoscopy

    CPT-00820-ANESTHESIA-LOWER-POSTERIOR-ABDOMINAL-WALL-PROCEDURES

    CPT 00820: Anesthesia for Lower Posterior Abdominal Wall Procedures

    CPT-00830-LOWER-ABDOMINAL-HERNIA-ANESTHESIA-UNSPECIFIED

    CPT 00830: Anesthesia for Lower Abdominal Hernia Repair, Unspecified

    CPT-00832-ANESTHESIA-LOWER-ABDOMEN-HERNIA-REPAIR

    CPT 00832: Anesthesia for Lower Abdominal Hernia Repair

    CPT-00834-INFANT-LOWER-ABDOMEN-HERNIA-ANESTHESIA

    CPT 00834: Anesthesia for Infant Lower Abdominal Hernia Repair

    CPT-00836-ANESTHESIA-INFANT-LOWER-ABDOMINAL-HERNIA-REPAIR

    CPT 00836: Anesthesia for Infant Lower Abdomen Hernia Repair

    CPT-00840-LOWER-ABDOMEN-INTRAPERITONEAL-ANESTHESIA-LAPAROSCOPY

    CPT 00840: Anesthesia for Lower Abdominal Intraperitoneal Procedures

    Showing 1–10 of 26

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
    Published by

    Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

    Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.