CPT 01926: Anesthesia for Therapeutic Endovascular Procedures Involving Aorta, Intracranial, Intracardiac
CPT code 01926 designates anesthesia services for therapeutic interventional radiology procedures targeting central arterial structures — specifically intracranial arteries, intracardiac vessels, and the aorta. This code captures anesthetic management for complex, image-guided endovascular or catheter-based interventions that commonly require advanced airway, hemodynamic monitoring, and coordination with procedural teams. Nationally, accurate use of this code supports appropriate payment for high-acuity anesthesia care associated with risk-intensive vascular procedures.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines payer coverage patterns and coding guidance relevant to these major payers, and situates 01926 within the broader anesthesia service portfolio.
Readers will gain a concise clinical and billing overview of when 01926 applies, how it differs from related anesthesia codes for diagnostic arteriography, and what clinical contexts typically trigger its use. The report also summarizes benchmarks and policy updates affecting anesthesia coding for interventional vascular procedures, and highlights important documentation elements that justify use of this code in a national context.
Sign up for cpt 01926 policy alerts
Get alerted when payer policies referencing 01926 are released or updated.
Billing Code Overview
CPT code 01926 describes anesthesia services provided for patients undergoing therapeutic interventional radiological procedures involving major central arteries: intracranial arteries within the skull, intracardiac vessels within the heart, or the aorta. These anesthesia services cover peri-procedural management to support imaging-guided endovascular or catheter-based therapeutic interventions.
Service Type
- Anesthesia for therapeutic endovascular/interventional radiology procedures involving intracranial arteries, intracardiac vessels, or the aorta.
Typical Site of Service
- Hospital operating room or interventional radiology suite where complex endovascular or catheter-based therapeutic procedures on central arteries are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with known atherosclerotic disease presents with an acute ischemic stroke due to an intracranial arterial occlusion. The interventional neuroradiology team plans an endovascular thrombectomy via femoral arterial access to remove the clot from an intracranial artery. The anesthesia team evaluates the patient pre-procedure, documents airway status, comorbidities (including coronary artery disease and chronic obstructive pulmonary disease), and assigns ASA physical status P3. Induction of general endotracheal anesthesia is performed in the angiography suite to provide immobility, airway protection, and optimal hemodynamic control during microcatheter manipulation and device deployment within the intracranial circulation. Intra-procedural management includes continuous hemodynamic monitoring, vasoactive medication as needed, and neurophysiologic assessment when indicated. At procedure conclusion the patient is extubated in the interventional radiology recovery area or transferred intubated to the intensive care unit depending on neurologic status. Documentation includes start and stop times for anesthesia, airway technique, medications administered, anesthetic depth, hemodynamic events, and any complications. This scenario reflects anesthesia services described by 01926 for therapeutic interventional radiological procedures involving intracranial arteries or other covered major vessels.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia — services provided in an emergency setting when general anesthesia is administered but not normally required for the procedure | Use when conversion to general anesthesia occurs for an otherwise normally sedated angiographic procedure due to patient condition or safety concerns |
50 | Bilateral procedure | Use when identical therapeutic endovascular interventions are performed on bilateral paired vessels when applicable |
52 | Reduced services | Use when the anesthesia service is intentionally reduced or partially discontinued prior to planned completion of the procedure |
53 | Discontinued procedure | Use when anesthesia is provided but the procedure is terminated for patient safety or intra-procedural complication |
59 | Distinct procedural service | Use when multiple anesthesia-related procedure codes are reported on the same day and services are separate and independent |
62 | Two surgeons/assistant at surgery (shared responsibility) — used analogously when two anesthesiologists share distinct anesthesia responsibilities | Use when primary and collaborating anesthesia professionals each provide separate portions of the anesthetic and documentation supports shared responsibility |
78 | Return to the operating/procedure room for a related procedure during the global period | Use when an additional therapeutic endovascular procedure under anesthesia occurs related to the original procedure during the global period |
AA | Anesthesia services performed personally by anesthesiologist | Use to indicate the reporting anesthesiologist personally performed the anesthetic care |
QK | Medical direction of two, three, or four certified registered nurse anesthetists (CRNAs) | Use when the physician medically directs multiple CRNAs during the procedure and documentation meets medical direction criteria |
QS | Monitored anesthesia care service | Use when monitored anesthesia care (MAC) rather than general anesthesia is provided and appropriate for the therapeutic intervention |
QX | CRNA service with medical direction by a physician | Use when a CRNA performs the anesthesia under medical direction documented by the physician |
QY | Medical direction of one CRNA by an anesthesiologist | Use when an anesthesiologist medically directs a single CRNA during the case |
CR | Catastrophic result | Use when a catastrophic complication attributable to the procedure occurs (per payer guidelines) |
GC | Service performed in part by a resident under the teaching physician's direction | Use when a resident provides portions of the anesthetic under appropriate teaching physician supervision |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists provide peri-procedural anesthesia care for complex neurovascular interventions |
367500000X | Certified Registered Nurse Anesthetist | CRNAs frequently deliver monitored anesthesia care or general anesthesia in angiographic suites under varying supervision models |
207LP2900X | Pain Medicine (Anesthesiology) | Pain medicine anesthesiologists may be involved in peri-procedural analgesia and complex perioperative pain management when indicated |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M54.2 | Cervicalgia | Cervical radiculopathy or neck pain may prompt vascular imaging or interventions addressing vertebral artery pathology in the cervical/skull base region |
M54.5 | Low back pain | Low back pain is included in the input list; while not directly intracranial, patients with chronic pain or prior spinal procedures may have comorbidities affecting peri-procedural anesthesia planning |
M51.9 | Intervertebral disc disorder, unspecified | Represents concurrent spinal pathology that may influence positioning, airway management, or anesthetic technique during endovascular procedures |
G89.29 | Other chronic pain | Chronic pain diagnoses affect perioperative analgesic planning and may alter sedative/opioid requirements during anesthesia for endovascular therapy |
G96.8 | Other specified disorders of central nervous system | Central nervous system disorders can be the indication for intracranial therapeutic interventions and affect neurologic monitoring and anesthetic risk assessment |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01916 | Anesthesia for diagnostic arteriography/venography (e.g., cerebral, visceral, peripheral vessels) | Diagnostic arteriography is often performed before or in conjunction with therapeutic interventions; 01916 covers anesthesia when the procedure is diagnostic rather than therapeutic and helps distinguish service intent from 01926 |