Summary & Overview
CPT 01937: Anesthesia for Image-Guided Cervical or Thoracic Spine Procedures
CPT code 01937 represents anesthesiology services for percutaneous image-guided injection, drainage, or aspiration procedures on the cervical or thoracic spine or spinal cord. This code captures the peri-procedural anesthesia component when clinicians provide monitoring, analgesia, sedation, or general anesthesia tailored to image-guided spinal interventions. Nationally, accurate use of CPT code 01937 affects resource allocation, claims adjudication, and quality measurement for spine interventional services.
Key payers commonly applying policies to this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for anesthesia during cervical and thoracic image-guided spinal procedures, typical sites of service, and which payers are relevant to coverage and coding considerations. The publication also summarizes benchmarking and policy updates where available, and explains the relationship of this anesthesia code to related procedural and billing concepts. Data not available in the input will be noted where applicable.
Billing Code Overview
CPT code 01937 describes anesthesia services provided for patients undergoing percutaneous image-guided injection, drainage, or aspiration procedures on the cervical or thoracic spine or spinal cord. This encompasses anesthetic management specific to minimally invasive, image-directed interventions targeting the cervical or thoracic regions of the spine.
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Service type: Anesthesia for percutaneous image-guided spinal procedures
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Typical site of service: Hospital operating room, ambulatory surgical center, or interventional radiology suite where image-guided cervical or thoracic spine procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 56-year-old patient presents with chronic, radicular cervical pain refractory to conservative management (physical therapy, oral analgesics, and epidural steroid injections). Imaging (MRI and CT) demonstrates focal cervical facet arthropathy and suspected cervical nerve root impingement. The interventional pain team schedules a percutaneous, image-guided cervical spine injection for diagnostic and therapeutic purposes under monitored anesthesia care. The anesthesia provider performs sedation and airway management appropriate for a cervical percutaneous injection procedure, monitors hemodynamics and neurologic status, and documents pre-procedure evaluation, intra-procedure anesthetic agents and dosages, physiologic monitoring, and post-anesthesia recovery. Typical workflow: pre-procedure evaluation and informed consent, transport to fluoroscopy/CT suite, positioning with immobilization of the cervical spine, sterile preparation, image-guided needle placement for injection/aspiration/drainage, local anesthetic with or without steroid, anesthesia sedation or MAC provided throughout the procedure, post-procedure monitoring in PACU, discharge with post-procedure instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual anesthesia | Use when anesthesia is medically necessary for a procedure that normally does not require general anesthesia (rarely for complex cervical procedures). |
50 | Bilateral procedure | Use when identical procedures are performed on both left and right sides during the same session. |
52 | Reduced services | Use when the service provided is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the procedure is started but terminated due to extenuating circumstances. |
54 | Surgical care only | Use to indicate the surgeon performed only the surgical portion; rarely appended to anesthesia claims when separate care segments are billed. |
55 | Postoperative management only | Use when a provider bills only for postoperative management (not typical for anesthesia claims). |
59 | Distinct procedural service | Use when a distinct and separate anesthesia-related procedure is performed on the same day and needs to be distinguished from another service. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons; may affect related surgical coding impacting anesthesia reporting. |
78 | Return to OR for related procedure during global period | Use when a patient requires an immediate return to the operating room for a related procedure; impacts anesthesia billing for the subsequent anesthesia service. |
AA | Anesthesia by anesthesiologist | Use when an anesthesiologist personally performs the anesthesia service. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Use when the physician medically directs multiple concurrent anesthesia procedures and meets required documentation. |
QS | Monitored anesthesia care service | Use to indicate monitored anesthesia care was provided when required by payer policy. |
QX | CRNA service with medical direction by physician | Use when a CRNA provides the anesthesia services under the medical direction of a physician. |
QY | CRNA service without medical direction by physician | Use when a CRNA provides services in a state allowed model without physician medical direction. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084P0800X | Pain Medicine | Interventional pain specialists commonly perform and coordinate these procedures. |
| 363A00000X | Anesthesiology | Anesthesiologists provide MAC, general anesthesia, and sedation for spine injections. |
| 2086S0102X | Physical Medicine & Rehabilitation | PM&R physicians perform image-guided spine injections for diagnostic and therapeutic care. |
| 207L00000X | Neurology | Neurologists with interventional training may be involved in diagnostic procedures. |
| 207K00000X | Orthopedic Surgery | Orthopedic spine surgeons perform related spine interventions and may request anesthesia support. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M50.12 | Cervical disc disorder with radiculopathy, mid-cervical region | Common indication for diagnostic/therapeutic cervical injections to relieve nerve root pain. |
M50.21 | Other cervical disc displacement, high cervical region | Disc pathology causing radiculopathy or myelopathy managed with image-guided injections. |
M53.83 | Other cervicalgia | Neck pain that may be managed diagnostically/therapeutically with cervical injections. |
M54.12 | Radiculopathy, cervical region | Radicular symptoms commonly targeted by cervical spine injections. |
M47.22 | Other spondylosis with radiculopathy, cervical region | Degenerative spine disease prompting targeted injections for pain relief. |
M48.02 | Spinal stenosis, cervical region | Central or foraminal stenosis producing symptoms treated or diagnosed with injections. |
G95.9 | Disease of spinal cord, unspecified | Rare but potential indication when spinal cord–related pathology requires image-guided diagnostic/therapeutic access. |
M54.2 | Cervicalgia | Localized neck pain commonly encountered in patients undergoing cervical injections. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01937 | Anesthesia for percutaneous image-guided injection, drainage, or aspiration procedures on the cervical or thoracic spine or spinal cord | Primary anesthesia code for this procedure (the code in question). |
64490 | Injection(s), diagnostic or therapeutic agent, paravertebral facet joint, cervical or thoracic; single level | Commonly performed as the targeted spinal injection that may be the reason anesthesia is provided. |
62287 | Injection procedure for diagnostic or therapeutic purposes; thoracic or cervical, single injection, including imaging guidance | Often performed with image guidance; anesthesia supports patient comfort and immobility. |
77002 | Fluoroscopic guidance for needle placement (single plane) | Imaging guidance code used during percutaneous spine injections; typically reported by the facility or radiology provider. |
76000 | Fluoroscopy (radiologic guidance) | Alternative imaging guidance code; used during needle placement when billed by the radiology or facility service. |
99152 | Moderate sedation services provided by the same physician/other qualified health care professional performing the diagnostic or therapeutic service, for initial 15 minutes | May be billed when moderate sedation is provided and billed separately from anesthesia services, depending on payer policy. |