Anesthesia Services
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This section lists applicable anesthesia CPT codes and brief descriptors for a wide range of procedures (abdominal, pelvic, urologic, orthopedic, vascular, radiologic, spine, and upper/lower extremity procedures) for coding and reimbursement use by providers and claims processors.
Removed G9654-G9658 and 99151-99157, these CPT codes are not valid when billed with modifiers AA, QK, QS, QY, QX and QZ.
Methodology for calculating anesthesia services changed from ASA methodology to CMS methodology.
Policy language updated to reflect transition from ASA to CMS.
Coverage criteria and applicable CPT codes
Coding details and code tables
| 00802 | Anesthesia for lower intestinal endoscopic procedures; endoscope introduced distal to duodenum |
| 00811 | Anesthesia for lower intestinal endoscopic procedures; endoscope introduced distal to duodenum; not otherwise specified |
| 00812 | Anesthesia for lower intestinal endoscopic procedures; endoscope introduced distal to duodenum; screening colonoscopy |
| 01916 | Anesthesia for diagnostic arteriography/venography; cardiac catheterization including coronary angiography and ventriculography |
| 01924 | Anesthesia for non-invasive imaging or radiation therapy |
| 01925 | Anesthesia for therapeutic interventional radiological procedures involving the arterial system; not otherwise specified |
| 01931 | Anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system; intrahepatic or portal circulation (e.g., TIPS) |
| 01938 | Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; lumbar or sacral |
| 01937 | Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord; cervical or thoracic |
| 01939 | Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; cervical or thoracic |
| 01940 | Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord; lumbar or sacral |
| 01941 | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (e.g., kyphoplasty, vertebroplasty) on the spine or spinal cord; cervical or thoracic |
| 01942 | Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (e.g., kyphoplasty, vertebroplasty) on the spine or spinal cord; lumbar or sacral |
Provider billing, claim submission, and actionable code lists
Report applicable CPT codes for lower abdomen/pelvic procedures on claims
Applicable anesthesia CPT codes for lower abdomen, pelvis and related procedures include, but are not limited to: 00800 (lower anterior abdominal wall), 00802, 00811, 00812, 00813 (anesthesia for lower intestinal endoscopic and combined GI endoscopic procedures), 00820 (procedures on lower posterior abdominal wall and hernia repairs), and codes for intraperitoneal procedures and laparoscopy as listed in the policy.
- 00800 — lower anterior abdominal wall
- 00802 — anesthesia for lower intestinal endoscopic procedures
- 00811 — endoscope introduced distal to duodenum; not otherwise specified
- 00812 — screening colonoscopy; lower intestinal endoscopic procedures
- 00813 — combined upper and lower GI endoscopic procedures
- 00820 — procedures on lower posterior abdominal wall; hernia repairs; intraperitoneal procedures including laparoscopy
Use specified knee/lower-extremity anesthesia CPT codes
For knee and lower-extremity procedures, use the specified anesthesia CPT codes when billing: examples include 01400 (anesthesia for open or arthroscopic procedures on the knee; not otherwise specified) and 01402 (anesthesia for total knee arthroplasty).
Bill using the anesthesia CPT codes for radiology/interventional/spine procedures
For interventional radiology, non‑invasive imaging, radiation therapy and spine image‑guided procedures, bill using the listed anesthesia CPT codes such as 01916, 01924–01926, 01930–01931 and related codes shown in the policy.
- 01916 — anesthesia for diagnostic arteriography/venography and cardiac catheterization
- 01924 — anesthesia for non-invasive imaging or radiation therapy
- 01925–01926 — anesthesia for therapeutic interventional radiological procedures involving the arterial system (including carotid/coronary/intracranial/intracardiac/aortic)
- 01930–01931 — anesthesia for therapeutic interventional radiological procedures involving the venous/lymphatic system
- 01938 — anesthesia for percutaneous image-guided spine procedures (see policy for additional spine procedure codes)
Report actual anesthesia time and comply with claim edits to avoid denials
Healthfirst requires actual anesthesia time (in minutes) to be reported on the claim and applies claim edits aligned with CMS and national standards; failure to follow coding/billing rules may result in denial or recoupment.
- Report actual anesthesia time in minutes on every claim (per CMS guidelines).
- Healthfirst's claim edits follow CMS/national standards (NCCI, NCD/LCD, modifier rules, global surgery/multiple procedure reductions, medically unlikely edits, duplicates).
- Noncompliance with coding/billing guidelines can result in claim denial and/or recoupment.
Definitions and code-family notes
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