CPT 01120: Anesthesia for Procedures on the Bony Pelvis
CPT code 01120 denotes anesthesia services furnished for procedures on the bony pelvis. This code captures anesthetic management for surgical interventions that involve pelvic bones and is used across hospital and ambulatory surgical settings. Accurate use of this code supports appropriate billing for complex perioperative anesthetic care tied to orthopedic, trauma, oncologic, or reconstructive pelvic procedures. Nationally, anesthesia coding for pelvic surgery affects reimbursement streams for anesthesia providers and facilities and contributes to case-mix and resource allocation analyses.
Key payers in the coverage landscape include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of clinical context for pelvic bony procedures, typical sites of service, common related anesthesia considerations, comparison to closely related anesthesia codes for pelvic procedures, and payer coverage patterns. The publication outlines benchmarking and billing considerations, lists common associated modifiers and diagnoses for reference, and highlights related anesthesia codes that may be reported for different pelvic procedure variants. The intent is to provide a concise reference for coding accuracy, billing clarity, and operational planning for anesthesia service lines.
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Billing Code Overview
CPT code 01120 describes anesthesia services provided for procedures on the bony pelvis. The service type is anesthesia for pelvic bony procedures, which includes administration and management of anesthetic care before, during, and immediately after surgical interventions involving the pelvic bones. The typical site of service is an inpatient or outpatient surgical setting where operative procedures on the pelvis are performed, such as hospital operating rooms or ambulatory surgery centers.
Clinical & Coding Specifications
Clinical Context
A 72-year-old female presents to the orthopedic service after a ground-level fall with severe pelvic pain and inability to bear weight. Imaging demonstrates a displaced pathological fracture of the pelvis consistent with osteoporosis. The patient is scheduled for open reduction and internal fixation of the pelvic ring under general endotracheal anesthesia. The anesthesia team performs preoperative assessment, documents ASA physical status P3 for multiple comorbidities (hypertension, chronic obstructive pulmonary disease), obtains informed consent for anesthesia, places standard monitors and arterial line for hemodynamic monitoring, induces general anesthesia with endotracheal intubation, provides intraoperative anesthetic management including blood loss replacement and analgesia, and coordinates postoperative handoff to PACU with anesthetic record documentation. Typical site of service is an inpatient operating room; occasionally procedures on the bony pelvis occur in an ambulatory surgical center for less complex procedures such as bone marrow biopsy of the iliac crest. Common payors include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia for pelvic surgery requires substantially greater work due to surgical complexity or prolonged management beyond typical for 01120. |
23 | Unusual anesthesia | Use when general anesthesia is medically required for a procedure usually performed with local/regional anesthesia. |
50 | Bilateral procedure | Use when identical pelvic procedures are performed bilaterally and reportable to anesthesia billing rules. |
52 | Reduced services | Use when the planned anesthetic is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when anesthesia is provided but the surgical procedure is terminated for patient-related or intraoperative reasons. |
54 | Surgical care only | Use when billing needs to designate that the surgical team provided only surgical care and anesthesia billing reflects separate anesthesia services. |
55 | Postoperative management only | Use if anesthesia billing is limited to postoperative management (rare for 01120). |
62 | Two surgeons | Use when two surgeons are required concurrently for complex pelvic reconstruction affecting anesthesia time and documentation. |
78 | Unplanned return to OR | Use when patient requires anesthesia for an unplanned return to the operating room related to the original pelvic procedure. |
AA | Anesthesia services performed personally by anesthesiologist | Use when an anesthesiologist personally performs the anesthesia. |
AD | Medical supervision by a physician; more than four concurrent anesthesia procedures | Use when physician supervises multiple concurrent anesthesia cases per CMS rules. |
QK | Medical direction of two or more CRNAs/AA by anesthesiologist | Use when anesthesiologist directs two or more CRNAs/Anesthesiologist Assistants for pelvic surgery. |
QS | Monitored anesthesia care service | Use when monitored anesthesia care is provided rather than general or regional anesthesia for a pelvic procedure. |
QX | CRNA service: furnished under physician direction | Use when a CRNA furnishes anesthesia under medical direction by an anesthesiologist. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physicians credentialed to provide and bill for medical direction or personally performed anesthesia services for pelvic procedures. |
367H00000X | Anesthesiologist Assistant | Providers who assist the anesthesiologist in delivery of anesthesia under supervision; applicable when documented and billed per payer rules. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who deliver anesthesia care for pelvic surgeries; billing and modifier use follow payer and CMS guidelines. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S32.9XXA | Fracture of unspecified part of lumbar spine and pelvis, initial encounter | Represents acute pelvic or lumbopelvic fractures requiring operative or nonoperative anesthetic management. |
M84.459A | Pathological fracture in neoplastic disease, pelvis, initial encounter | Pathological pelvic fractures from malignancy that may require surgical stabilization under anesthesia. |
M87.051 | Idiopathic aseptic necrosis of pelvis | Avascular necrosis of pelvic bone that can necessitate operative intervention with anesthesia. |
M80.059A | Age-related osteoporosis with current pathological fracture, pelvis, initial encounter | Osteoporotic pelvic fracture commonly requiring fixation or stabilization and anesthesia management. |
S32.2XXA | Fracture of coccyx, initial encounter | Coccygeal fractures that may require procedural anesthesia for reduction, fixation, or pain procedures. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01112 | Anesthesia for procedures on the pelvis (except hip) – bone marrow aspiration or biopsy of iliac crest | Used for anesthesia specific to iliac crest bone marrow aspiration/biopsy; a less invasive pelvic bone procedure compared to open fixation covered by 01120. |
01130 | Anesthesia for procedures on the pelvis (except hip) – body cast application or revision | Used when anesthesia is required for body cast application or revision involving the pelvis; may be performed in the same clinical pathway for pelvic fracture management when casting is chosen instead of surgical fixation. |