Summary & Overview
CPT 01938: Anesthesia for Image-Guided Lumbar/Sacral Spinal Procedures
CPT code 01938 covers anesthesia services furnished during percutaneous, image-guided injection, drainage, or aspiration procedures on the lumbar or sacral spine or spinal cord. This code is used when an anesthesia provider manages sedation or anesthesia care specific to these lower spinal interventional procedures. Nationally, accurate use of this code matters because it distinguishes anesthesia for targeted image-guided spinal interventions from other regional or general anesthesia services, supporting correct billing, quality measurement, and resource allocation across care settings.
Key payers included in this coverage overview are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find contextual information about the clinical setting and service type, typical sites of service where billing occurs, and common operational considerations for coding and billing these anesthesia services. The publication outlines benchmarks and payment policy context relevant to national payers, highlights clinical scenarios where 01938 is applicable, and summarizes typical modifier usage where available in input data.
This summary serves clinicians, billing professionals, and policymakers seeking a concise reference for the clinical scope of CPT code 01938, how it is positioned among anesthesia services for image-guided lumbar and sacral spine procedures, and what to expect in payer coverage and coding practice. Data not available in the input will be noted in the detailed sections.
Billing Code Overview
CPT code 01938 describes anesthesia services provided for percutaneous image-guided injection, drainage, or aspiration procedures on the lumbar or sacral spine or spinal cord. The code represents anesthesia management specifically for procedures targeting the lower spine region where imaging guidance is used to place needles or catheters for injection, aspiration, or drainage.
Service type: Procedural anesthesia for image-guided percutaneous spinal interventions.
Typical site of service: Hospital outpatient department, ambulatory surgical center, or interventional radiology suite where image-guided lumbar or sacral spine procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient with chronic low back pain and radiating leg pain presents for a percutaneous, image-guided lumbar epidural steroid injection for diagnostic and therapeutic purposes. The patient has a history of lumbar degenerative disc disease and prior conservative care that failed to provide durable relief. The interventional radiology or pain management team reviews imaging (MRI) and the pre-anesthesia assessment, confirms no contraindications (active infection, coagulopathy), and obtains informed consent. On the day of service the anesthesia provider documents airway assessment, ASA physical status, and plan for monitored anesthesia care (MAC) or sedation. Under fluoroscopic or CT guidance the proceduralist advances the needle to the targeted lumbar epidural space, injects contrast for confirmation, then administers steroid and local anesthetic. The anesthesia provider administers sedation or monitored anesthesia, titrates medications for patient comfort, continuously monitors vitals, documents drug dosages and airway interventions, and remains available for immediate management of complications such as hypotension or respiratory depression. The typical site of service is an outpatient ambulatory surgery center or hospital procedure suite, with recovery area observation until discharge criteria are met.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual Anesthesia | Use when anesthesia is medically necessary for an otherwise non‑anesthetic procedure due to unusual circumstances. |