CPT 01933: Anesthesia for Intracranial Interventional Radiology
CPT code 01933 covers anesthesia services for therapeutic interventional radiological procedures involving the intracranial venous or lymphatic system. This code captures anesthetic care for high-acuity, image-guided neurointerventional procedures that often require specialized monitoring and airway management. Nationally, accurate use of this code is important for aligning clinical documentation with anesthesia reimbursement and for tracking utilization of complex neurointerventional services. Key payers in typical coverage analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 01933, comparisons to closely related anesthesia codes used for interventional radiology, and actionable reference material on common billing considerations and coding relationships. The publication highlights where 01933 fits within the anesthesia code set for interventional radiology, typical sites of service, and common clinical scenarios that prompt its use. It also summarizes payer coverage scope and prevalent coding practices relevant to national billing and policy discussions. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 01933 describes anesthesia services provided for patients undergoing therapeutic interventional radiological procedures involving the intracranial venous or lymphatic system. The service type is anesthesia for intracranial interventional radiology, which encompasses anesthetic management specific to complex, image-guided therapeutic procedures targeting intracranial venous or lymphatic structures. The typical site of service is an interventional radiology suite or hybrid operating room where specialized neurointerventional procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with a history of progressive headaches and radiographically confirmed dural venous sinus thrombosis is scheduled for an endovascular thrombolysis and mechanical thrombectomy involving the intracranial venous system. The patient arrives at the interventional radiology suite after pre-procedure evaluation in the hospital. An anesthesiology team performs a focused pre-anesthesia assessment including airway evaluation, review of anticoagulation and imaging, and consent for monitored anesthesia care or general endotracheal anesthesia depending on procedural complexity and patient comorbidities. Induction of anesthesia (general or monitored anesthesia care) occurs in the IR suite with invasive hemodynamic monitoring as needed. During the therapeutic interventional radiological procedure involving the intracranial venous or lymphatic system, the anesthesiologist manages ventilation, hemodynamics, and neurologic monitoring in coordination with the interventional radiologist/neurointerventionalist. Post-procedure, the patient is extubated in the suite or recovered in the post-anesthesia care unit with ongoing neurologic checks and anticoagulation management per the interventional team.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When anesthesia care is markedly more complex or time-consuming than usual due to procedural difficulty or patient factors |
23 | Unusual anesthesia | When general anesthesia is administered for a procedure that normally would not require it |
50 | Bilateral procedure | When identical procedures are performed bilaterally in the same session (rare for intracranial venous procedures) |
52 | Reduced services | When the service is partially reduced or not completed as planned |
53 | Discontinued procedure | When anesthesia is discontinued due to extenuating circumstances after initiation |
62 | Two surgeons/lead surgeon secondary | When two qualified anesthesia providers participate and one is designated as second/an assistant for technical reasons (use per payer rules) |
78 | Return to the operating/procedure room for a related procedure during the global period | When a related anesthesia service is provided during a return trip to procedure room for the same condition |
AA | Anesthesia services performed personally by anesthesiologist | When the billing anesthesiologist personally performed the anesthesia service |
AD | Medical supervision by a physician; more than four concurrent anesthesia procedures | When supervising physician provides medical direction for more than four concurrent cases |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | When a qualified non-physician anesthesia practitioner furnishes the anesthesia service per payer rules |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | When a physician medically directs multiple concurrent anesthesia providers (specific to Medicare/QC rules) |
QS | Monitored anesthesia care service | When MAC is provided and payer requires explicit reporting separate from general anesthesia |
QX | CRNA service: CRNA with medical direction by a physician | When a certified registered nurse anesthetist (CRNA) furnishes the service under physician direction |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Primary specialty providing peri-procedural anesthesia management for intracranial venous/lymphatic IR procedures |
207LP2900X | Pain Medicine Physician | May be involved if procedure addresses pain-related indications or complex analgesic planning |
207RA0000X | Radiology Physician | Interventional radiology or neurointerventional specialists perform the therapeutic procedure; anesthesia coordinates support |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M54.5 | Low back pain | May be present as a comorbid pain diagnosis in patients undergoing spinal or venous access planning; relevant for pain history and peri-procedural analgesia planning |
M54.2 | Cervicalgia | Cervical spine pain as a comorbidity that may affect positioning or airway management during anesthesia |
M51.26 | Other intervertebral disc displacement, lumbar region | Chronic spinal pathology that can influence peri-procedural analgesic needs and positioning for access |
M47.812 | Spondylosis without myelopathy or radiculopathy, cervical region | Cervical degenerative disease impacting airway assessment and positioning considerations for anesthesia |
M48.06 | Spinal stenosis, lumbar region | Lumbar spinal stenosis as a comorbidity potentially affecting neuraxial anesthesia decisions and positioning |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01930 | Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation) | Used for anesthesia when the procedure involves peripheral venous/lymphatic interventions without central circulation access; an alternative related anesthesia code depending on access site |
01931 | Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation) | Related anesthesia code differing by complexity or site; selected based on procedure specifics and payer guidelines |
01932 | Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system (not to include access to the central circulation) | Related code for other variants of venous/lymphatic interventional procedures; used when procedure descriptors match CPT provisions |