Summary & Overview
CPT 01936: Anesthesia for Image-Guided Spine Procedures
CPT code 01936 was a billing code used to report anesthesia services for image-guided procedures on the spine or spinal cord, primarily in outpatient hospital settings. This code played a significant role in capturing the complexity and clinical value of anesthesia support during minimally invasive spinal interventions. Nationally, the code was recognized by major commercial payers, including Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for these specialized services.
The publication provides a comprehensive overview of the clinical context for CPT code 01936, including its application, typical site of service, and its relevance to anesthesia providers. Readers will learn about the code's deletion effective January 1, 2022, and how this impacts billing practices and policy updates. The summary also highlights related codes for similar procedures, common modifiers used in anesthesia billing, and associated provider taxonomies. Benchmarks and policy changes are discussed to inform stakeholders about evolving reimbursement and reporting standards for image-guided spinal procedures. This resource is designed to support healthcare professionals, administrators, and policy analysts in understanding the historical and current landscape of anesthesia coding for spinal interventions.
CPT Code Overview
CPT code 01936 represented anesthesia services for image-guided procedures performed on the spine or spinal cord. These procedures typically took place in an outpatient hospital setting, designated as Place of Service 22. The code was used to capture the professional work of anesthesia providers during minimally invasive, image-guided interventions targeting spinal structures. As of January 1, 2022, CPT code 01936 has been deleted and is no longer in use for billing or reporting these services.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to an outpatient hospital setting with symptoms related to peripheral vascular disease, such as leg pain, intermittent claudication, or signs of arterial insufficiency. The patient is scheduled for an image-guided procedure on the spine or spinal cord, which may be indicated for pain management or diagnostic evaluation. Anesthesia services are provided to ensure patient comfort and safety during the procedure, with monitoring for potential complications related to vascular disease and anesthesia. The clinical workflow includes pre-procedure assessment, administration of anesthesia, intra-procedure monitoring, and post-procedure recovery.
Coding Specifications
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Modifiers:
Modifier Description QSMonitored anesthesia care service QXCRNA service with medical direction by a physician - Use
QSwhen anesthesia is provided as monitored anesthesia care. - Use
QXwhen a Certified Registered Nurse Anesthetist (CRNA) provides the service under physician direction.
- Use
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Provider Taxonomies:
Taxonomy Code Specialty 207L00000XAnesthesiology 207RA0000XCritical Care Medicine Physician 367H00000XAnesthesiologist Assistant 207L00000Xrepresents board-certified anesthesiologists.207RA0000Xrepresents physicians specializing in critical care medicine.367H00000Xrepresents anesthesiologist assistants.
Related Diagnoses
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I70.203- Unspecified atherosclerosis of native arteries of extremities, bilateral legs- Indicates generalized arterial disease in both legs, relevant for patients undergoing spinal procedures due to vascular compromise.
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I73.9- Peripheral vascular disease, unspecified- Represents a broad diagnosis of vascular disease, often associated with pain or dysfunction requiring intervention.
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I74.3- Embolism and thrombosis of arteries of the lower extremities- Indicates acute vascular events, which may necessitate urgent procedures and anesthesia support.
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I70.213- Atherosclerosis of native arteries of extremities with intermittent claudication, bilateral legs- Describes patients with pain during walking due to arterial narrowing, relevant for procedural planning and anesthesia risk assessment.
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I70.293- Other atherosclerosis of native arteries of extremities, bilateral legs- Covers additional forms of arterial disease in both legs, important for understanding patient comorbidities during spinal procedures.
Related CPT Codes
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01937- Anesthesia for percutaneous image‑guided procedures on the spine or spinal cord (diagnostic)- Used for diagnostic image-guided spinal procedures; may be an alternative to the deleted code
01936.
- Used for diagnostic image-guided spinal procedures; may be an alternative to the deleted code
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01938- Anesthesia for percutaneous image‑guided procedures on the spine or spinal cord (therapeutic)- Used for therapeutic image-guided spinal procedures; often follows diagnostic procedures.
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01939- Anesthesia for percutaneous image‑guided destruction procedures by neurolytic agent on the spine or spinal cord- Used when neurolytic agents are applied for pain management.
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01940- Anesthesia for percutaneous image‑guided destruction procedures by neurolytic agent on the spine or spinal cord- Similar to
01939, may be used as an alternative depending on procedure specifics.
- Similar to
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01941- Anesthesia for percutaneous image‑guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord- Used for neuromodulation or vertebral augmentation procedures.
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01942- Anesthesia for percutaneous image‑guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord- Often used in conjunction with or as an alternative to
01941for similar procedures.
- Often used in conjunction with or as an alternative to
National Reimbursement Benchmarks
National mean rates for CPT code 01936 show significant variation between commercial payers. Blue Cross Blue Shield and Cigna report higher mean rates, with Cigna at $746.94 and Blue Cross Blue Shield at $314.33. UnitedHealth Group is notably lower at $79.79, while the BUCA average is $190.02. Medicare rates are not available in the input for comparison.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for BUCA ($208.00) and Cigna ($230.00), indicating greater variability in reimbursement. Blue Cross Blue Shield has a tighter range ($89.00), and UnitedHealth Group is the tightest ($49.00), suggesting more consistent rates across providers for these payers.
The table and chart below present the full breakdown of national benchmarks for CPT code 01936 by payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska shows a substantial rate spread for CPT code 01936, especially among Blue Cross Blue Shield and UnitedHealth Group. Blue Cross Blue Shield's 75th percentile rate is $475.00, while its 25th percentile is $371.50, resulting in a spread of $103.50. UnitedHealth Group has a much narrower spread, with a 75th percentile of $65.00 and a 25th percentile of $58.00, a difference of only $7.00. Cigna's rates are uniform, with all percentiles at $474.50, indicating no spread.
Compared to national averages, both Blue Cross Blue Shield and Cigna in Alaska pay significantly more for CPT code 01936, while UnitedHealth Group pays less than its national mean. The table and chart below present the full payer breakdown for Alaska, highlighting these differences.
Key Insights for Alaska
- Cigna is the highest paying payer for CPT 01936 in Alaska, with a mean rate of $474.50.
- UnitedHealth Group is the lowest paying payer, with a mean rate of $69.87, significantly below both state and national averages.
- Blue Cross Blue Shield and Cigna rates in Alaska are notably higher than their respective national averages, indicating a premium for this code in the state.
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