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Anesthesia Billing Guide
- Anesthesia Billing Codes
- Anesthesia Billing Modifiers
- Anesthesia
- Concurrent, Medical Direction and Supervision
- Daily Management and Pain Management
- Group/Member Practice Responsibilities
- Local Coverage Determinations
- Moderate (Conscious) Sedation
- Monitoring Anesthesia Services
- National Coverage Determinations
- Payment and Reimbursement
- Provider Qualifications
- Teaching Anesthesiology Services
- Resources and References
- Related Articles
Anesthesia Billing Codes
Table of Contents
Anesthesia
| Body Area | CPT Codes |
|---|---|
| Head | 00100‒00222 |
| Neck | 00300‒00352 |
| Thorax (chest and shoulder) | 00400‒00474 |
| Intrathoracic | 00500‒00580 |
| Spine and Spinal Cord | 00600‒00670 |
| Upper Abdomen | 00700‒00797 |
| Lower Abdomen | 00800‒00882 |
| Perineum | 00902‒00952 |
| Pelvis (excludes hip) | 01112‒01173 |
| Upper (excludes knee) | 01200‒01274 |
| Knee and popliteal area | 01320‒01444 |
| Lower leg (below knee, includes ankle and foot) | 01462‒01522 |
| Shoulder and axilla | 01610‒01680 |
| Upper arm and elbow | 01710‒01782 |
| Forearm, wrist and hand | 01810‒01860 |
| Radiological procedure | 01916‒01942 |
| Burn excisions or debridement | 01951‒01953 |
| Obstetric | 01958‒01969 |
| Other procedures | 01990‒01999 |
Note: The Affordable Care Act amended Section 1833(b)(1) of the Act, which waives the Part B deductible for screening colonoscopies also includes anesthesia services as an inherent part of the screening colonoscopy procedural service. These provisions are effective for services furnished on or after 1/1/2011.
In the CY 2018 PFS Final Rule, the CMS modified reporting and payment for anesthesia services furnished in conjunction with and in support of colorectal cancer screening services.
Anesthesia services furnished in conjunction with and in support of a screening colonoscopy are reported with CPT code 00812 (Anesthesia for lower intestinal endoscopic procedures, endoscope introduced distal to duodenum; screening colonoscopy). CPT Code 00812 will be added as part of 1/1/2018 HCPCS update. Effective for claims with dates of service on or after 1/1/2018, Medicare will pay claim lines with new CPT code 00812 and waive the deductible and coinsurance.
When a screening colonoscopy becomes a diagnostic colonoscopy, anesthesia services are reported with CPT code 00811 (Anesthesia for lower intestinal endoscopic procedures, endoscopy introduced distal to duodenum; not otherwise specified) and with the PT modifier. CPT code 00811 will be added as part of the 1/1/2018 HCPCS update. Effective for claims with dates of service on or after 1/1/2018, Medicare will pay claim lines with new CPT code 00811 and waive only the deductible when submitted with the PT modifier.
Not Otherwise Classified Codes
By report – There are “not otherwise classified” codes for all individual body regions. Instead of billing procedure code 01999, providers should use the code for the specific body region involved in the surgery for which anesthesia was provided.
Add-On Codes for Anesthesia
Add-on codes exist for anesthesia involving burn excisions or debridement and obstetrical anesthesia. The add-on code is billed in conjunction to the primary anesthesia code.
For example: In the burn excision/debridement code, 01953 is used in conjunction with code 01952. All anesthesia time should be reported only with the primary anesthesia code involving burn excisions or debridement.
In the obstetrical area, code 01968 or 01969 is used in conjunction with code 01967.
All anesthesia time should be reported with the primary anesthesia code. There is an exception for obstetrical anesthesia. Anesthesia time for the obstetrical codes should be reported separately on the primary code and the add-on code.
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Revised 10/28/2024