Summary & Overview
CPT 00212: Anesthesia for Intracranial Subdural Tap
CPT 00212 represents anesthesia services for intracranial procedures involving subdural taps, a targeted intraoperative anesthesia code used when addressing subdural fluid collections or pressure relief. Nationally, this code is important because it specifies anesthesia care for a narrow but clinically significant neurosurgical intervention, informing coding accuracy, billing consistency, and resource planning in hospital-based surgical services. Key private payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise review of the code’s clinical context and relevance to anesthesia service lines, a summary of common billing modifiers and professional taxonomies associated with the service, and references to related intracranial anesthesia CPT entries for procedural comparison. The publication outlines typical inpatient hospital utilization and highlights associated ICD-10 diagnoses commonly paired with the procedure to support clinical coding alignment. Benchmarks and policy considerations related to anesthesia coding for intracranial procedures are discussed to aid coding professionals, billing staff, and policy analysts in ensuring accurate claim submission and interpretation. Data not available in the input is identified where applicable.
CPT Code Overview
CPT 00212 denotes anesthesia for intracranial procedures specifically for subdural taps. This code is used to report anesthesia services provided during procedures that access the subdural space to remove or sample fluid or relieve pressure. The service type is Anesthesia and the typical site of service is Inpatient Hospital (POS 21).
Clinical & Coding Specifications
Clinical Context
A typical inpatient neurosurgical patient presents with symptoms of increased intracranial pressure or symptomatic subdural hygroma/hematoma following trauma or neurosurgical intervention. The patient is admitted to the hospital (Inpatient Hospital, POS 21) for evaluation and management. Neurosurgery determines a diagnostic and/or therapeutic subdural tap is required to remove subdural fluid or relieve pressure. Anesthesia evaluates the patient preoperatively, documents airway assessment, comorbidities, and anesthetic plan, and provides anesthesia services during the procedure appropriate to the patients condition (commonly monitored anesthesia care or anesthesia directed by an anesthesiologist with a CRNA). Post-procedure monitoring occurs in the inpatient setting with attention to neurologic status and respiratory function.
Coding Specifications
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Common modifiers listed:
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QS- Monitored anesthesia care service: Use when the anesthesia provided is monitored anesthesia care (MAC) rather than general anesthesia. -
QX- CRNA service with medical direction by a physician: Use when a Certified Registered Nurse Anesthetist (CRNA) furnishes the anesthesia service under medical direction by an anesthesiologist. -
Associated provider taxonomies:
| Taxonomy Code | Specialty |
|---|---|
207L00000X | Anesthesiology |
367500000X | Certified Registered Nurse Anesthetist |
207RA0401X | Anesthesiology Assistant |
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Notes on usage:
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Use
QSwhen the documented service meets criteria for monitored anesthesia care and payer policies allow MAC reporting for the intracranial subdural tap procedure. -
Use
QXwhen service documentation supports that a CRNA performed the service under medical direction by an anesthesiologist and payer policy permits the modifier. -
If additional modifiers are required by specific payors (e.g., medical direction, physical status), those are not included here because they were not provided in the input.
Related Diagnoses
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C32.0— Malignant neoplasm of glottisRelevance: A patient with laryngeal malignancy may have compromised airway anatomy or prior treatments affecting airway management; airway considerations may influence anesthetic planning for intracranial procedures.
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J38.00— Paralysis of vocal cords and larynx, unspecifiedRelevance: Vocal cord or laryngeal paralysis can affect airway patency and aspiration risk, impacting anesthesia induction and airway device selection during intracranial procedures.
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J95.02— Acute pulmonary insufficiency following thoracic surgeryRelevance: Postoperative pulmonary insufficiency can increase perioperative respiratory risk and influence monitoring and ventilatory management during anesthesia for an intracranial subdural tap.
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Q31.0— Congenital laryngomalaciaRelevance: Congenital laryngomalacia is associated with dynamic airway obstruction, which may alter anesthetic approach and airway equipment choice for the procedure.
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R09.3— Abnormal sputumRelevance: Abnormal sputum may indicate underlying pulmonary infection or secretion burden, affecting aspiration risk and perioperative respiratory care during anesthesia for intracranial procedures.
Related CPT Codes
| CPT Code | Description |
|---|---|
00211 | ANES ICR PX CRANIOTOMY/CRANIECTOMY HMTMA |
00214 | ANES INTRACRANIAL PX BURR HOLES W/VENTRG |
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Relationship to
00212: -
00211(ANES ICR PX CRANIOTOMY/CRANIECTOMY HMTMA): This code represents anesthesia services for more extensive intracranial procedures such as craniotomy or craniectomy. It is used for open cranial procedures and is an alternative when the surgical procedure is a craniotomy/craniectomy rather than a subdural tap. -
00214(ANES INTRACRANIAL PX BURR HOLES W/VENTRG): This code covers anesthesia for intracranial procedures involving burr holes with ventricular procedures. It may be used in similar neurosurgical workflows when burr hole access or ventricular drainage is performed instead of or in addition to a subdural tap. -
Common usage notes:
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These codes may be used in the same clinical service line when multiple intracranial procedures are performed during one anesthetic; coding sequence and payer rules determine primary anesthesia code selection.
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00211,00212, and00214are related anesthesia code options corresponding to differing intracranial surgical procedures and are selected based on the specific surgical procedure documented.
National Reimbursement Benchmarks
Nationwide commercial averages sit above Medicare for this CPT code: BUCA (average commercial benchmark) posts a mean of $138.84 versus Medicare at $0.00 in the input. Blue Cross Blue Shield and Cigna show notably higher commercial means at $301.95 and $299.28, respectively, while UnitedHealth Group and Aetna report lower means at $65.62 and $163.35.
Dispersion varies materially across payers. Cigna has the widest spread between the 75th and 25th percentiles (433.00 - 89.00 = $344.00), followed by BCBS (390.00 - 204.75 = $185.25). UnitedHealth Group and Aetna display the tightest distributions (UHC: 75.67 - 50.33 = $25.34; Aetna: 300.00 - 40.00 = $260.00 — note Aetna's spread is larger than UHC despite a lower mean). The table and chart below present the full breakdown.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a significant spread in reimbursement rates for CPT code 00212, with Blue Cross Blue Shield showing the widest range between the 25th and 75th percentiles ($96.90), and BUCA also exhibiting a substantial spread ($159.15). In contrast, Aetna, Cigna, and UnitedHealth Group have much narrower spreads, with their 25th, 50th, and 75th percentiles clustered closely together. This indicates that some payers in Alaska have consistent rates, while others vary considerably depending on provider contracts.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are notably higher, while Cigna and UnitedHealth Group are below their respective national means. The table and chart below present the full breakdown of payer-specific rates in Alaska for CPT code 00212.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 00212, with a mean rate of $330.74.
- UnitedHealth Group offers the lowest mean rate at $75.12.
- Alaska's mean rates for most payers are notably higher than national averages, especially for Blue Cross Blue Shield and BUCA.
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