Summary & Overview
CPT 01939: Anesthesia for Percutaneous Neurolytic Cervical/Thoracic Spine Procedures
CPT code 01939 represents anesthesia services for percutaneous image-guided neurolytic destruction procedures of the cervical or thoracic spine or spinal cord. This code captures anesthesia management when a neurolytic agent is used to ablate neural tissue under imaging guidance, a procedure relevant for select pain management and palliative interventions. Nationally, accurate use of this code matters for appropriate reimbursement, clinical documentation, and tracking of interventional pain services.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage practices, common modifiers seen with anesthesia and interventional codes, and clinical context for when 01939 applies. The publication outlines benchmarks for utilization and billing patterns, summarizes relevant policy considerations affecting authorization and payment, and clarifies the clinical scenarios where percutaneous neurolytic spinal procedures are performed under anesthesia.
The content is intended for billing professionals, anesthesiologists, interventional pain specialists, and policy analysts seeking a concise reference on coding, expected sites of service, and payer coverage themes for anesthesia associated with cervical and thoracic neurolytic spinal procedures.
Billing Code Overview
CPT code 01939 describes anesthesia services provided for percutaneous image-guided neurolytic destruction procedures targeting the cervical or thoracic spine or spinal cord. The provider administers anesthesia while a neurolytic agent is used to destruct nerve tissue under image guidance.
Service type: Anesthesia for neurolytic spinal procedures
Typical site of service: Hospital outpatient department, ambulatory surgery center, or interventional radiology suite
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with intractable cancer‑related neck pain refractory to medication is scheduled for a percutaneous image‑guided neurolytic destruction of cervical sympathetic ganglia using ethanol. The interventional pain physician performs preprocedure evaluation, reviews imaging and coagulation status, obtains informed consent, and coordinates with anesthesia for monitored anesthesia care. The procedure is performed in an interventional radiology or ambulatory surgical suite under fluoroscopic or CT guidance. The provider administers neurolytic agent to the cervical or thoracic spinal ganglia to ablate nociceptive fibers. Postprocedure monitoring includes neurologic checks, hemodynamic observation for hypotension or bradycardia, and discharge instructions for potential sensory or motor changes. Typical workflow steps: preprocedure assessment and consent, IV access and sedation/airway planning, image localization, needle placement, neurolytic injection, immediate postprocedure observation, and documentation of level, laterality, agent, volume, and any complications.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required is substantially greater than typical due to complexity or prolonged time. |
23 |