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.
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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. |
23 | Unusual anesthesia | Use when general anesthesia is medically necessary but not normally required for the procedure (e.g., inability to tolerate local/regional techniques). |
50 | Bilateral procedures | Use when bilateral pelvic procedures are performed during the same anesthetic event involving symphysis pubis or both sacroiliac joints. |
52 | Reduced services | Use when the anesthesia service is partially reduced or not fully performed as planned. |
53 | Discontinued procedure | Use when the procedure is terminated after induction of anesthesia for reasons unrelated to patient improvement. |
62 | Two surgeons | Use when two qualified anesthesiologists are required to manage complex intraoperative needs (rare for this code; apply if documented). |
78 | Unplanned return to the operating/procedure room | Use when patient requires a return to procedure room for complications related to the initial procedure during the global period. |
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally performs the anesthesia service. |
AD | Medical supervision by a physician; medically directed anesthesia service | Use when the anesthesiologist medically directs qualified nonphysician anesthesia providers for more than four concurrent cases. |
AS | Physician assistant of anesthesiology | Use when a physician assistant of anesthesiology performs the anesthesia service under appropriate direction. |
QK | Medical direction of two to four concurrent anesthesia procedures | Use when an anesthesiologist directs qualified CRNAs for two to four concurrent cases. |
QS | Monitored anesthesia care (MAC) service | Use when MAC services are provided and reporting requirements specify this modifier. |
QX | CRNA service with CRNA certification on file | Use when a CRNA performs the service and is supervised as required. |
QY | Medical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist | Use when the anesthesiologist medically directs one CRNA. |
QZ | CRNA service without medical direction by a physician | Use when a CRNA performs the service without physician medical direction. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Primary specialty for delivery of anesthesia services for pelvic procedures. |
207LA0401X | Pain Medicine (Anesthesiology) | Relevant when sacroiliac joint injections are performed for diagnostic/therapeutic pain management. |
207LC0200X | Critical Care Medicine (Anesthesiology) | Applicable if patient requires critical care perioperative management due to comorbid conditions. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
J34.2 | Deviated nasal septum | Not directly related to pelvic anesthesia; included in input list but clinically unrelated to sacroiliac/symphysis pubis procedures. |
J32.9 | Chronic sinusitis, unspecified | Not directly related to pelvic procedures; may influence airway management or anesthesia risk if active. |
J34.89 | Other specified disorders of nose and nasal sinuses | Not directly related to pelvic procedures; may affect airway assessment. |
J33.9 | Nasal polyp, unspecified | Not directly related to pelvic procedures; relevant only if nasal pathology affects airway or sedation tolerance. |
J34.3 | Hypertrophy of nasal turbinates | Not directly related to pelvic procedures; potentially relevant to airway management during sedation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01150 | Under Anesthesia for Procedures on the Pelvis (Except Hip) | Alternative anesthesia code for other pelvic procedures; may be used when the procedure falls outside the specific symphysis pubis/sacroiliac joint descriptor. |
01170 | Under Anesthesia for Procedures on the Pelvis (Except Hip) | Related anesthesia code used for other types of pelvic procedures; selected based on the exact surgical site and operative documentation. |