Summary & Overview
CPT 01160: Anesthesia for Closed Symphysis Pubis or Sacroiliac Joint Procedures
CPT code 01160 designates anesthesia services for closed procedures targeting the symphysis pubis or sacroiliac joint. The code captures perioperative anesthetic management for these specific pelvic procedures and is used in national billing and reimbursement workflows for anesthesia providers. Accurate use of this code affects anesthesia service reporting, resource tracking, and claims adjudication across payers.
This analysis covers major national payers including Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of clinical context for anesthesia care in closed pelvic procedures, how 01160 aligns with related anesthesia procedure codes, and payer considerations that commonly arise in claims processing. The publication provides benchmarks and policy-relevant notes on coding adjacency and clinical scenarios where 01160 is applicable, along with comparisons to nearby CPT anesthesia codes.
Intended for clinicians, coding staff, and revenue cycle professionals, the summary explains the clinical situations represented by 01160, highlights documentation needs implicit in anesthesia service reporting, and outlines the scope of payer coverage discussed. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 01160 represents anesthesia services provided for patients undergoing closed procedures involving the symphysis pubis or sacroiliac joint. This billing code describes intraoperative anesthesia care rendered during closed pelvic procedures focused on the symphysis pubis or sacroiliac joint.
Service type: Anesthesia services for closed pelvic procedures
Typical site of service: Operating room or procedural suite
Clinical & Coding Specifications
Clinical Context
A 45-year-old patient with chronic pelvic pain attributed to sacroiliac joint dysfunction is scheduled for a closed diagnostic and therapeutic procedure involving the sacroiliac joint under monitored anesthesia care. The patient presents to an ambulatory surgical center after preoperative evaluation by the anesthesiology team (ASA classification P2). Preoperative workflow includes verification of indications (localized SI joint pain refractory to conservative management), informed consent for anesthesia, review of comorbidities and medications, and establishment of IV access. During the procedure, the anesthesiologist provides sedation and analgesia appropriate for a closed joint injection or manipulation at the symphysis pubis or sacroiliac joint, monitors airway, hemodynamics, and pain control, and documents total anesthetic agents, fluids, and any intraoperative events. Postprocedure, the patient is recovered in PACU, with discharge criteria documented once stable. Typical sites of service are ambulatory surgery centers or hospital outpatient departments for closed procedures on the pelvis (symphysis pubis or sacroiliac joint).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the anesthesia provider documents substantially greater time, difficulty, or intensity than typically required for this anesthesia service. |