CPT 01965: Anesthesia for Incomplete or Missed Abortion Procedure - OpenPayer

Summary & Overview

CPT 01965: Anesthesia for Incomplete or Missed Abortion Procedure

CPT code 01965 identifies anesthesia services provided for incomplete or missed abortion procedures. This code is important nationally because it captures anesthesia resources, billing classification, and utilization for a specific gynecologic operative service that can occur in multiple ambulatory and hospital outpatient settings. Accurate use of the code supports appropriate payment, quality measurement, and clinical resource planning for reproductive health services.

Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of payer coverage patterns, coding context, and clinical scenarios where 01965 applies. The publication outlines where this code fits within obstetric/gynecologic anesthesia practice, typical sites of service, and common clinical indications for use. It also highlights related procedural links and diagnostic pairings relevant for billing and claims processing. The content is intended to assist revenue cycle, coding, and policy teams in recognizing the clinical and billing role of CPT code 01965 across national payers.

AetnaBlue Cross Blue ShieldCigna HealthUnited HealthcareMedicare01965CPTAnesthesiaGynecologyAbortion careAmbulatory surgeryHospital outpatientRevenue cycle

Billing Code Overview

CPT code 01965 denotes anesthesia services provided for an incomplete or missed abortion procedure. The service type is anesthesia for gynecologic operative procedure. The typical site of service is an outpatient surgical setting or ambulatory procedure unit, including hospital outpatient departments and ambulatory surgery centers where abortion-related operative procedures are performed.

Clinical & Coding Specifications

Clinical Context

A 28-year-old female presents to the outpatient ambulatory surgery center with vaginal bleeding and cramping after a confirmed incomplete spontaneous abortion at 10 weeks gestation. She has stable vital signs but ongoing heavy bleeding and retained tissue on ultrasound. The obstetrics and gynecology team schedules an operative uterine evacuation (manual vacuum aspiration or dilation and curettage) under monitored anesthesia care. The anesthesia team — either an anesthesiologist (207L00000X) or a certified registered nurse anesthetist (367500000X) working with an OB/GYN (207V00000X) — performs anesthesia services documented as anesthesia for incomplete or missed abortion, reported with 01965.

Pre-procedure workflow includes informed consent, review of allergies and medications, assessment of airway and comorbidities (ASA physical status documented), and establishment of intravenous access. Typical anesthesia care may consist of monitored anesthesia care with sedation or general anesthesia depending on patient factors, pain control needs, and procedure complexity. Intra-procedure documentation captures time in/out, agents administered, airway management, hemodynamic stability, and any complications. Post-procedure recovery occurs in the ambulatory post-anesthesia care unit with monitoring until discharge criteria are met. Coding of 01965 is performed by the anesthesia provider and may include applicable modifiers to indicate unusual circumstances, concurrent services, or provider qualifications.

Coding Specifications

Modifier

Related Codes

01963

CPT 01963: Anesthesia for Cesarean Hysterectomy Without Labor Analgesia

01968

CPT 01968: Anesthesia for Cesarean Delivery After Neuraxial Labor Analgesia

cpt-01962-urgent-postpartum-hysterectomy-anesthesia

CPT 01962: Anesthesia for Urgent Postpartum Hysterectomy

01960

CPT 01960: Anesthesia for Vaginal Delivery

cpt-01968-cesarean-delivery-anesthesia-after-neuraxial

CPT 01968: Anesthesia for Cesarean Delivery After Neuraxial Anesthetic

cpt-01920-coronary-angiography-ventriculography-anesthesia

CPT 01920: Anesthesia for Coronary Angiography and Ventriculography

01920

CPT 01920: Anesthesia for Cardiac Catheterization and Coronary Angiography

01926

CPT 01926: Anesthesia for Therapeutic Interventional Radiological Procedures

01961

CPT 01961: Anesthesia for Cesarean Delivery Only

cpt-01958-anesthesia-external-cephalic-version

CPT 01958: Anesthesia for External Cephalic Version

Showing 1–10 of 55

`23`	Unusual anesthesia — usually non-anesthetic procedure or service	Use when anesthesia is required for a procedure that normally does not require anesthesia (rare for abortion-related procedures but applicable if unusual circumstances exist).
`52`	Reduced service	Use when anesthesia service is partially reduced or not completed as originally planned (e.g., brief sedation stopped early).
`53`	Discontinued procedure	Use when anesthesia is provided but the procedure is terminated for clinical reasons before completion.
`62`	Two surgeons	Use when two qualified anesthesia providers are required concurrently (rare; apply only per payer rules for anesthesia team reporting).
`78`	Unplanned return to the operating room following initial procedure	Use when the patient returns to the OR for a complication related to the incomplete/missed abortion requiring additional anesthesia.
`AA`	Anesthesia services performed personally by anesthesiologist	Use when an anesthesiologist personally performs the anesthesia service.
`AD`	Medical supervision by anesthesiologist with one CRNA	Use when an anesthesiologist supervises a CRNA during the case.
`AS`	Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant-at-surgery	Use when an advanced practice professional assists in surgery and reporting rules require the AS modifier for payers that accept it.
`QK`	Medical direction of two to four concurrent anesthesia procedures involving qualified individuals	Use when the anesthesiologist medically directs multiple concurrent anesthesia providers and payer accepts `QK`.
`QS`	Monitored anesthesia care service	Use to indicate monitored anesthesia care services when payer requires this modifier in addition to the anesthesia CPT.
`QX`	CRNA service furnished under physician supervision	Use when a CRNA performs the service and a physician is present for supervision, per payer policy.
`QY`	Medical direction of one CRNA by an anesthesiologist	Use when the anesthesiologist directs a CRNA for the case and documents medical direction.
`XE`	Separate encounter	Use when the anesthesia service is distinct and separate from other services provided on the same day (unrelated).

Taxonomy Code	Specialty	Notes
`207L00000X`	Anesthesiology	Primary specialty for physicians providing anesthesia services for `01965`.
`367500000X`	Certified Registered Nurse Anesthetist	CRNAs commonly provide anesthesia services in ambulatory and hospital settings for uterine evacuation procedures.
`207V00000X`	Obstetrics & Gynecology Physician	OB/GYN performs the surgical procedure and coordinates perioperative care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`O82`	Encounter for cesarean delivery without indication	Included when coding obstetric encounters that progress to cesarean; shows relevance for anesthesia workflows if procedure converts to operative delivery.
`O34.211`	Maternal care for low transverse scar from previous cesarean delivery	Relevant when prior cesarean scar impacts management or anesthesia planning for current uterine procedures.
`O66.5`	Failed trial of labor after previous cesarean delivery	Relevant in scenarios where prior uterine surgery complicates labor management and anesthesia needs escalate.
`O75.82`	Maternal exhaustion complicating labor and delivery	Reflects intrapartum complications that may require anesthesia intervention or urgent operative management.
`Z37.0`	Single live birth	Used to document outcome of delivery-related encounters; may be present in the obstetric record when related procedures occur in the same episode of care.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`01967`	Anesthesia for labor and vaginal delivery	May be reported when anesthesia care transitions to labor analgesia or when procedures related to vaginal delivery require anesthesia; clinically adjacent but distinct from abortion services.
`01968`	Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia	Related for intrapartum conversions to cesarean delivery; not typically used for incomplete/missed abortion but relevant when obstetric escalation occurs.
`59510`	Routine obstetric care including antepartum care, cesarean delivery, and postpartum care	Represents global obstetric care bundle; relevant when cesarean delivery or full obstetric services are billed in the same episode but not a direct companion to `01965`.
`59514`	Cesarean delivery only	Applicable when cesarean delivery is performed and anesthesia services for cesarean are billed separately; included as related obstetric surgical code in workflows that escalate from uterine evacuation to cesarean.