CPT 01931: Anesthesia for Therapeutic Interventional Radiology on Liver Circulation
CPT code 01931 denotes anesthesia services delivered during therapeutic interventional radiology procedures targeting intrahepatic or portal circulation — the vascular system within the liver. This code is used when anesthesia care is required for image-guided treatments such as catheter-directed therapies or embolization that access the liver’s blood supply. Nationally, accurate use of this code matters for clinical documentation, appropriate payment for anesthesia teams, and consistent reporting of resource use for complex hepatic interventions.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise clinical context for when 01931 applies, an outline of typical settings where the service is delivered, and pointers to related anesthesia and interventional radiology procedures. The publication also summarizes common billing considerations and related procedural codes to help clarify coding relationships for complex ophthalmic and hepatic interventional scenarios.
This overview is intended for a national audience of anesthesia providers, interventional radiology teams, coding professionals, and payor policy analysts seeking clear guidance on the clinical scope and billing context of CPT code 01931.
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Billing Code Overview
CPT code 01931 describes anesthesia services provided for therapeutic interventional radiological procedures on intrahepatic or portal circulation. This code covers anesthesia care when the procedure targets blood circulation within the liver, such as catheter-directed treatments or embolization procedures.
Service type: Anesthesia for therapeutic interventional radiology procedures on intrahepatic or portal circulation.
Typical site of service: Hospital interventional radiology suite or ambulatory surgical center where image-guided liver vascular procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with primary hepatocellular disease is scheduled for a therapeutic interventional radiology procedure targeting the intrahepatic portal circulation (for example, transarterial chemoembolization or portal vein embolization) that requires general anesthesia. Preoperative evaluation documents limited functional status and comorbidities (e.g., controlled hypertension and mild chronic obstructive pulmonary disease). The patient arrives to the outpatient interventional radiology suite or an inpatient angiography/interventional radiology operating room. The anesthesia team (anesthesiology physician and/or certified registered nurse anesthetist) performs the pre-anesthesia assessment, obtains informed consent, establishes intravenous access, and induces general anesthesia with airway management as indicated. Intraoperative monitoring includes continuous ECG, pulse oximetry, end-tidal CO2, invasive arterial monitoring if indicated, and hemodynamic support during embolization of intrahepatic or portal vessels. Postprocedure, the patient is transferred to the post-anesthesia care unit for recovery and monitoring of hemodynamics and potential complications (bleeding, hepatic ischemia, or postembolization syndrome). Documentation includes anesthesia start and end times, airway technique, monitoring modalities, anesthetic agents, fluid and blood product administration, vasoactive medications, and immediate postoperative condition.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia delivery required substantially greater work due to complexity, prolonged procedure, or atypical physiologic difficulty beyond typical for the service. |
23 | Unusual anesthesia | Use when general anesthesia is administered for a procedure that is normally performed with local or monitored anesthesia care but general anesthesia is required for medical reasons. |
50 | Bilateral procedure | Use if identical procedures are performed on both paired organs; rarely applicable but used if bilateral hepatic/portal interventions documented as separate sides. |
52 | Reduced services | Use when the procedure is partially reduced or not completed as originally planned and documented. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances or patient condition. |
62 | Two surgeons | Use when co-surgeons are required and documented for distinct portions of the procedure affecting anesthesia billing coordination. |
77 | Repeat procedure by another physician | Use when a subsequent anesthesiologist provides anesthesia for a repeat IR procedure during the same encounter. |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for a related procedure during the global period | Use if patient requires immediate return for a related interventional radiology procedure and separate anesthesia is provided. |
79 | Unrelated procedure or service by the same physician during the post-operative period | Use if a separate unrelated anesthetic service is provided in the global period. |
AA | Anesthesia by anesthesiologist | Use to identify services personally performed by a physician anesthesiologist. |
QK | Medical direction of two, three, or four CRNAs by a physician | Use when the anesthesiologist medically directs multiple CRNAs for concurrent cases per required documentation. |
QS | Monitored anesthesia care service (MAC) | Use when monitored anesthesia care is billed in lieu of general anesthesia and documentation supports MAC for the interventional procedure. |
QX | CRNA service with anesthesia care team modifier - CRNA | Use when a CRNA provides services under the direction of an anesthesiologist and payer requires designation. |
QY | Medical direction of one CRNA by an anesthesiologist | Use when one CRNA is medically directed by an anesthesiologist and documentation meets requirements. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology Physician | Physician specialists who provide perioperative anesthesia care and medical direction. |
367500000X | Certified Registered Nurse Anesthetist | Advanced practice providers who deliver anesthesia services under state law; may be medically directed by anesthesiologists. |
207W00000X | Ophthalmology Physician | Included in input taxonomy list; not typically primary for intrahepatic/portal anesthesia but may be present in dataset; note: not routine for this procedure. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
H25.9 | Unspecified age-related cataract | Included in input; ophthalmic diagnosis not directly related to intrahepatic/portal anesthesia but present in dataset. |
H26.9 | Unspecified cataract | Included in input; ophthalmic diagnosis present in dataset; not clinically related to hepatic interventional anesthesia. |
H52.4 | Presbyopia | Included in input; refractive condition listed in dataset; not relevant to hepatic/portal procedures. |
H53.8 | Other specified visual disturbances | Included in input; ophthalmic symptom code present in dataset; not directly relevant to intrahepatic/portal anesthesia. |
H54.8 | Legal blindness, as defined in USA | Included in input; vision impairment diagnosis present in dataset; may be relevant to perioperative consent/communication needs but not to the indication for intrahepatic/portal intervention. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | Listed in input; unrelated to hepatic/portal anesthesia clinically but appears as an associated ophthalmic code in the dataset; not part of typical IR workflow. |
66982 | Complex cataract surgery with insertion of intraocular lens prosthesis | Listed in input; ophthalmic complex cataract code present in dataset; not ordinarily related to intrahepatic/portal interventional procedures. |
01932 | Anesthesia for procedures on eye; other than lens surgery | Listed in input; an ophthalmic anesthesia code included in the dataset though not applicable to intrahepatic portal interventions. |
01933 | Anesthesia for procedures on eye; vitrectomy | Listed in input; ophthalmic anesthesia code present in the provided related codes list but not clinically linked to intrahepatic/portal IR procedures. |