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2025 CPT code 00604

Anesthesia for procedures on the cervical spine and cord with the patient in a sitting position.

Modifiers may be applicable to indicate specific circumstances, such as unusual anesthesia (23), the physical status of the patient (P1-P6), or the involvement of a CRNA or anesthesiologist's assistant (e.g. QX,QY,QZ,AA,AD,QK).

Medical necessity is established by the diagnosis requiring the cervical spine procedure performed in a sitting position. The documentation should clearly indicate why the procedure and the chosen patient position are necessary.

The anesthesiologist is responsible for the patient's well-being before, during, and immediately after the cervical spine procedure. This includes assessing the patient's condition, administering anesthesia, monitoring vital signs, managing any complications, and ensuring a smooth transition to post-operative care.

In simple words: The anesthesiologist provides pain relief and care for a patient undergoing a neck operation where they are seated. This includes checking the patient before and after surgery, giving medication to make them sleep and managing their condition during the surgery.

This code represents anesthesia services for procedures performed on the cervical spine and spinal cord while the patient is in a sitting position. It includes pre- and post-operative evaluation, anesthesia induction, maintenance, and monitoring during the procedure, administration of fluids/blood, and post-anesthesia care. Monitoring typically includes ECG, temperature, blood pressure, oximetry, capnography, and mass spectrometry. It does not include unusual monitoring like Swan-Ganz catheters, intra-arterial lines, or central venous lines, which can be coded separately.

Example 1: A patient undergoes a posterior cervical laminectomy in a sitting position for spinal stenosis. Code 00604 is reported for anesthesia services., A patient with cervical disc herniation has an anterior cervical discectomy and fusion performed in the sitting position. Code 00604 is used for the anesthesia services provided., A patient has a cervical spinal cord tumor removed while in a sitting position. 00604 covers the anesthesia provided.

Documentation should include pre-anesthesia assessment, type and amount of anesthesia administered, monitoring methods used, patient response, anesthesia start and stop times, and post-anesthesia care notes. Any unusual monitoring or complications should also be documented.

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