CPT 01963: Anesthesia for Cesarean Hysterectomy - OpenPayer

Summary & Overview

CPT 01963: Anesthesia for Cesarean Hysterectomy

CPT code 01963 represents anesthesia services provided for a cesarean hysterectomy — the removal of the uterus performed at the time of a cesarean delivery. This code is used when anesthesia is administered specifically for the hysterectomy portion of a cesarean procedure and does not include labor analgesia or routine intrapartum anesthesia. Nationally, accurate use of this code affects perioperative billing, bundled payment calculations, and anesthesia workload reporting for complex obstetric surgeries.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The analysis highlights payer coverage considerations and common clinical scenarios that justify reporting 01963, such as planned cesarean hysterectomy for abnormal placentation or uterine rupture diagnosed at delivery.

Readers will find a concise explanation of the clinical context for 01963, comparisons to closely related anesthesia codes, and common ICD-10 diagnoses that align with the service. The publication also summarizes common billing modifiers used with intraoperative anesthesia in complex obstetric cases and practical coding distinctions between cesarean-only anesthesia and anesthesia for combined cesarean-hysterectomy. Data not available in the input is noted where relevant.

AetnaBlue Cross Blue ShieldCigna HealthUnited HealthcareMedicare01963CPTanesthesiacesarean-hysterectomyobstetric-surgeryintraoperative-careoperating-roomperioperative-billing

Billing Code Overview

CPT code 01963 describes anesthesia services provided for a cesarean hysterectomy, which is the surgical removal of the uterus performed at the time of a cesarean delivery. The service covers anesthesia care specifically for the hysterectomy portion of the combined cesarean and hysterectomy procedure and does not include labor analgesia or routine anesthesia for labor.

Service type: Intraoperative anesthesia for cesarean hysterectomy

Typical site of service: Operating room during cesarean delivery

Clinical & Coding Specifications

Clinical Context

A 33-year-old gravida 3 para 2 patient presents at 38 weeks gestation for a scheduled cesarean delivery due to a prior low transverse cesarean scar (O34.211). During the cesarean delivery, the obstetric team determines that total hysterectomy is required because of uncontrolled hemorrhage and uterine atony complicated by obstructed labor (O66.9) and primary inadequate contractions (O62.0). The anesthesia provider is called to deliver general endotracheal anesthesia for the cesarean hysterectomy procedure. The anesthesia service coded with 01963 covers anesthetic management for the combined cesarean delivery with concomitant hysterectomy; labor analgesia was not provided prior to the procedure. Typical workflow: preoperative evaluation in the labor and delivery unit, rapid induction of general anesthesia in the operating room, intraoperative hemodynamic management and blood product coordination, postoperative transfer to recovery or intensive care as indicated. Diagnoses on the record commonly include O82 (encounter for cesarean delivery without indication) when documentation emphasizes delivery, as well as O75.82 for maternal exhaustion contributing to labor complications.

Coding Specifications

Modifier	Description	When to Use

CPT 01960: Anesthesia for Obstetric Vaginal Delivery

cpt-01951-anesthesia-burn-excision-debridement-less-than-4pct-bsa

CPT 01951: Anesthesia for Excision/Debridement of <4% Total Body Surface Area

cpt-01958-anesthesia-external-cephalic-version

CPT 01958: Anesthesia for External Cephalic Version

01920

CPT 01920: Anesthesia for Cardiac Catheterization and Coronary Angiography

cpt-01936-anesthesia-image-guided-percutaneous-vascular-procedure

CPT 01936: Anesthesia for Percutaneous Image-Guided Vascular Procedure

01930

CPT 01930: Anesthesia for Peripheral Venous and Lymphatic Interventions

01932

CPT 01932: Anesthesia for Interventional Radiology Procedures (Venous/Lymphatic)

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

CPT 01967: Neuraxial Anesthesia for Planned Vaginal Delivery

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

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

cpt-01962-urgent-postpartum-hysterectomy-anesthesia

CPT 01962: Anesthesia for Urgent Postpartum Hysterectomy

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`22`	Increased procedural services	Use when documentation supports substantially greater work or complexity due to severe hemorrhage or complicated anesthesia management for cesarean hysterectomy.
`23`	Unusual anesthesia	Use when general anesthesia is required for a procedure that is normally performed with regional anesthesia and documentation supports medical necessity.
`50`	Bilateral procedure	Rare for hysterectomy; generally not applied to `01963` but included when a bilateral descriptor is relevant to anesthesia coding conventions.
`52`	Reduced services	Use when the anesthesia service is partially reduced or curtailed, with documentation of limitation.
`53`	Discontinued procedure	Use when anesthesia was administered but the procedure was terminated for clinical reasons before planned completion.
`62`	Two surgeons/Co-surgeons	Use when two surgeons of different specialties share the operative procedure and payer rules require the modifier.
`78`	Unplanned return to OR	Use when the patient requires an immediate return to the operating room for a related procedure during the same global period.
`AA`	Anesthesia by the anesthesiologist	Use when an MD or DO anesthesiologist personally performs the anesthesia service.
`AD`	Medical supervision by a physician; more than four concurrent anesthesia procedures	Use when the physician provides medical direction/supervision with CRNA involvement and more than four concurrent cases are supervised.
`QK`	Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals	Use when an anesthesiologist medically directs multiple concurrent CRNA-administered anesthetics and documentation meets criteria.
`QS`	Monitored anesthesia care service	Not typical for `01963` but used when MAC rather than general/regional anesthesia is provided.
`QX`	CRNA service with medical direction by physician (modifier QK/QY suite)	Use when a CRNA furnishes the anesthesia under an anesthesiologist's medical direction (payer-specific).
`QY`	Medical direction by a physician of one certified registered nurse anesthetist	Use when physician directs a single CRNA case meeting direction criteria.
`SH`	Increased procedural services by a non-physician anesthetist	Use per payer guidance when CRNA documents increased complexity beyond typical.

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Physician anesthesiologists commonly code `01963` when providing direct anesthesia services for cesarean hysterectomy.
`367500000X`	Certified Registered Nurse Anesthetist	CRNAs provide anesthesia care for cesarean hysterectomy under varied supervision/ direction models; modifier use depends on payer rules.
`207V00000X`	Obstetrics & Gynecology Physician	Obstetric surgeons perform the cesarean and hysterectomy; anesthesia coding interfaces with obstetric operative documentation.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O82`	Encounter for cesarean delivery without indication	Indicates the patient is undergoing cesarean delivery; supports the obstetric component of `01963`.
`O75.82`	Maternal exhaustion complicating labor and delivery	May contribute to decision for cesarean delivery and need for urgent operative management including hysterectomy.
`O62.0`	Primary inadequate contractions	Labor dystocia that can lead to operative delivery and potential complications requiring hysterectomy.
`O66.9`	Obstructed labor, unspecified	Obstruction can precipitate complex cesarean delivery and increased anesthetic and surgical complexity.
`O34.211`	Maternal care for low transverse scar from previous cesarean delivery	Prior uterine scar is a common indication for repeat cesarean and may influence intraoperative risk and decision for hysterectomy.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`01962`	Anesthesia for urgent hysterectomy following delivery	Used when hysterectomy occurs emergently after delivery; distinguishes urgency context from planned cesarean hysterectomy.
`01961`	Anesthesia for cesarean delivery only	Represents anesthesia for cesarean delivery without concurrent hysterectomy; contrasted with `01963` when hysterectomy is not performed.
`01965`	Anesthesia for incomplete or missed abortion procedures	Different obstetric/anesthesia context; listed for code family relevance but not typically used with cesarean hysterectomy.
`01966`	Anesthesia for induced abortion procedures	Related by anesthesia service grouping for obstetric procedures but not used for cesarean hysterectomy cases.

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