CPT 01935: Anesthesia for Percutaneous Image-Guided Spine Diagnostic Procedures - OpenPayer

Summary & Overview

CPT 01935: Anesthesia for Percutaneous Image-Guided Spine Diagnostic Procedures

CPT code 01935 denotes anesthesia for percutaneous image-guided diagnostic procedures on the spine and spinal cord. This code applies when anesthesia services are provided to support minimally invasive diagnostic interventions that rely on imaging guidance. Nationally, accurate coding for these procedures affects anesthesia billing, hospital outpatient and ambulatory surgery center workflows, and proper identification of resources used for spine diagnostic care.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find coverage considerations and payer inclusion, clinical context linking the code to image-guided spinal diagnostic procedures, and related service definitions. The publication outlines common coding relationships and adjacent codes relevant to procedural and imaging support.

The report provides practical benchmarks and policy-relevant context for medical billing and revenue cycle teams, anesthesia departments, and clinical program managers. It summarizes the clinical scope of 01935, typical sites of service, common diagnostic indications for image-guided spinal procedures, and related procedural codes. The content is intended to help coding and compliance teams align documentation with national billing practices and to clarify where 01935 is used in the continuum of spine diagnostic services.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare01935CPTanesthesiaspineimage-guideddiagnostic-procedureambulatory-surgeryhospital-outpatientanesthesiology

Billing Code Overview

CPT code 01935 describes anesthesia for percutaneous image-guided procedures on the spine and spinal cord; diagnostic. The service covers administration of anesthesia during minimally invasive, image-guided diagnostic procedures involving the spine or spinal cord. The service type is anesthesia for image-guided spinal diagnostic procedures. The typical site of service is an ambulatory surgical center or hospital outpatient department where percutaneous, image-guided spinal diagnostic interventions are performed.

Clinical & Coding Specifications

Clinical Context

A 54-year-old patient with chronic low back pain (M54.5) refractory to conservative care is scheduled for a diagnostic percutaneous, image-guided procedure of the lumbar spine to localize a suspected facet-mediated pain generator. The patient presents to an ambulatory surgical center where pre-anesthesia assessment documents prior response to medications, allergy status, airway exam, and ASA classification. Under fluoroscopic guidance, an interventional pain physician performs diagnostic medial branch blocks using 77003 for imaging guidance and 62323 or 64483 techniques for needle placement and injection. An anesthesiologist or certified registered nurse anesthetist provides monitored anesthesia care or sedation appropriate for a percutaneous image-guided spinal diagnostic procedure. Intra-procedure documentation includes the anesthetic technique, agents and dosages, monitoring, airway management, and any unexpected events. Post-procedure recovery includes pain assessment, neurologic check, and discharge instructions. Billing uses 01935 for anesthesia specific to percutaneous image-guided diagnostic procedures on the spine/spinal cord; relevant modifiers are appended as indicated by clinical circumstances (for example, provider service line, anesthesia medical direction, unusual procedural difficulty, or patient-related intraoperative events). Payers involved may include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare depending on patient coverage.

Coding Specifications

Modifier

CPT 01963: Anesthesia for Cesarean Hysterectomy

cpt-01952-anesthesia-burn-excision-debridement-4-9-tbsa

CPT 01952: Anesthesia for Burn Excision/Debridement, 4–9% TBSA

cpt-01958-anesthesia-external-cephalic-version

CPT 01958: Anesthesia for External Cephalic Version

cpt-01922-anesthesia-noninvasive-imaging-radiation-therapy

CPT 01922: Anesthesia for Non‑Invasive Imaging or Radiation Therapy

01958

CPT 01958: Anesthesia for External Cephalic Version

cpt-01991-anesthesia-for-nerve-block-injection-non-prone

CPT 01991: Anesthesia for Diagnostic or Therapeutic Nerve Block/Injection

cpt-01953-anesthesia-burn-excision-debridement-additional-9pct-tbsa

CPT 01953: Anesthesia for Burn Excision/Debridement per Additional 9% TBSA

cpt-01967-neuraxial-anesthesia-planned-vaginal-delivery

CPT 01967: Neuraxial Anesthesia for Planned Vaginal Delivery

cpt-01924-anesthesia-therapeutic-interventional-arterial-procedures

CPT 01924: Anesthesia for Therapeutic Arterial Interventional Radiology Procedures

01953

CPT 01953: Anesthesia for Burn Excision or Debridement, Additional 9% TBSA

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`AA`	Anesthesia services performed personally by anesthesiologist	When the anesthesiologist personally performs the anesthesia for the procedure
`AS`	Physician service: monitored anesthesia care	When monitored anesthesia care (MAC) is provided rather than general anesthesia
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	When the physician medically directs CRNAs for concurrent `01935` services meeting CMS supervision rules
`QX`	CRNA service with medical direction by a physician	When a CRNA provides the anesthesia and a physician medically directs and documents requirements
`QY`	Medical direction of one CRNA by an anesthesiologist	When a physician provides medical direction of one CRNA for the service
`62`	Two surgeons	When two qualified practitioners (e.g., co-surgical anesthesiologists for complex airway/monitoring needs) are required and each documents their role
`23`	Unusual anesthesia — medically necessary but not ordinarily justifying general anesthesia	When the procedure or patient condition necessitates deeper-than-typical anesthesia for a diagnostic spinal procedure
`22`	Unusual procedural services — increased procedural services	When the anesthesia care required is substantially greater in intensity, time, or complexity than typically required for `01935` (documentation required)
`52`	Reduced services	When the anesthesia service is partially reduced or not fully performed as originally planned
`53`	Discontinued procedure	When the anesthesia is provided but the procedure is terminated before completion for patient or medical reasons
`56`	Preoperative evaluation only	When anesthesia preoperative evaluation is performed but the anesthesia service itself is not completed
`55`	Postoperative management only	When only postoperative anesthesia management/consultation is provided separate from intraoperative anesthesia for `01935`
`54`	Surgical care only	When billing distinguishes that the anesthesia professional provided only the surgical/anesthesia intraoperative care portion — used rarely for anesthesia billing delineation
`FX`	Primary anesthesiologist not certified in pain medicine	When the primary anesthesiologist lacks pain medicine certification and a pain medicine physician provides co-management; used per payer rules

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Primary specialty that furnishes anesthesia services for image-guided spinal procedures
`207LP2900X`	Pain Medicine Physician	Performs the interventional diagnostic procedure; may co-manage sedation/anesthesia decisions for diagnostic blocks
`207RA0000X`	Radiation Oncology Physician	Rarely involved; included because of image-guidance overlap in some facilities where radiation oncologists perform fluoroscopically guided spine procedures

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M54.5`	Low back pain	Common indication for diagnostic percutaneous image-guided lumbar procedures to identify pain generators prior to therapeutic intervention
`M54.2`	Cervicalgia	Cervical spine pain may prompt diagnostic image-guided injections and anesthesia when performing cervical medial branch or selective nerve root blocks
`M54.6`	Pain in thoracic spine	Thoracic dorsalgia can be evaluated with percutaneous image-guided diagnostic injections that require anesthesia support
`M54.9`	Dorsalgia, unspecified	Non-specific back pain classification often used when the exact spinal pain source is undetermined prior to diagnostic blocks
`G89.29`	Other chronic pain	Chronic pain syndromes are an overarching indication for diagnostic procedures to localize spinal pain sources and plan treatment

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`77003`	Fluoroscopic guidance and localization for needle placement (eg, biopsy, aspiration, injection, or catheter placement); spine	Provides real-time imaging guidance used during percutaneous diagnostic spinal procedures billed with `01935`
`62323`	Injection(s), of diagnostic or therapeutic substance(s), including anesthetic agent, or neurolytic agent; single level, lumbar or sacral	Diagnostic or therapeutic injections that may be performed during the same visit; imaging and anesthesia support billed separately
`64483`	Injection(s) for nerve block, lumbar or sacral; including imaging guidance when applicable	Common nerve block code for lumbar medial branch or other spinal nerve blocks performed in the diagnostic workflow alongside anesthesia `01935`
`01936`	Anesthesia for percutaneous image guided procedures on the spine and spinal cord; therapeutic	Used when anesthesia is furnished for therapeutic (rather than diagnostic) percutaneous image-guided spinal procedures; complements `01935` in code sets

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