2025 CPT code 00813

Anesthesia for combined upper and lower gastrointestinal endoscopic procedures where the endoscope is introduced both proximally and distally to the duodenum.

Refer to the current CPT® manual and other relevant coding guidelines for the most up-to-date information on coding anesthesia services for gastrointestinal endoscopic procedures.

Modifiers may be appended to this code as necessary to indicate specific circumstances (e.g., anesthesia location, type of anesthesia, etc.). Consult the current CPT® manual and payer specific guidelines.

Medical necessity for anesthesia during combined upper and lower GI endoscopy is determined by the patient's clinical condition, including the presence of significant comorbidities, risk of complications, and anticipated patient discomfort. Factors such as age, medical history and potential need for airway management can influence this decision.Documentation should clearly support the clinical indication for anesthesia.

The anesthesiologist is responsible for the pre-operative evaluation of the patient, induction and maintenance of anesthesia during the procedure, monitoring vital signs and administering medications and fluids as needed. Post-operatively, the anesthesiologist oversees the patient's transfer to post-anesthesia care.

IMPORTANT May be used in conjunction with codes 00731 and 00811, depending on the specific procedures performed.If only a screening colonoscopy is performed, 00812 is the appropriate code.If the procedures are not combined, then separate codes for upper (00731 or 00732) and lower (00811 or 00812) endoscopy should be used.

In simple words: This code covers the anesthesia services a doctor provides when a patient has both an upper and lower endoscopy at the same time. The doctor gives the patient medicine to keep them comfortable and monitors them closely during the procedure and helps with their recovery afterwards.

This CPT code encompasses anesthesia services provided during combined upper and lower gastrointestinal endoscopic procedures.The procedure involves the introduction of an endoscope into the intestines both proximal (nearer to the point of attachment) and distal (farther from the point of attachment) to the duodenum. The anesthesiologist's responsibilities include pre-operative evaluation, induction and monitoring of anesthesia during the procedure, administration of medications and fluids as needed, and standard monitoring (ECG, temperature, blood pressure, oximetry, capnography, and mass spectrometry), and post-operative oversight of patient transfer.

Example 1: A patient undergoes an EGD with biopsy and a colonoscopy with biopsy for evaluation of dysphagia and lower GI bleeding.Both procedures are performed under general anesthesia., A patient with a history of Crohn's disease undergoes a combined EGD and colonoscopy with biopsies. General anesthesia is required due to the patient's complex medical history and anticipated discomfort., A patient with severe GERD and suspected colorectal cancer undergoes a combined EGD and colonoscopy. The patient also has severe anxiety, requiring general anesthesia for both procedures.

* Detailed pre-operative assessment of the patient's medical history, including any allergies or comorbidities.* Documentation of the type and amount of anesthesia medications administered.* Thorough record of vital signs and monitoring data throughout the procedure.* Documentation of any complications or adverse events.* Time spent performing anesthesia services and the time units used for billing purposes.* Post-operative notes documenting patient recovery and transfer to post-anesthesia care.

** Careful documentation is crucial for accurate coding and reimbursement.Always refer to the most current CPT® guidelines, payer-specific policies, and medical record documentation before assigning this code.

  • Revenue Code: 0010 (Anesthesia)
  • RVU: Refer to the CMS national physician fee schedule for the most current RVU values.These values vary based on geographic location and other factors.
  • Global Days : The global period for anesthesia services is typically considered to be included within the anesthesia time itself and not separately defined in days. The billing units are calculated based on time, not days.
  • Payment Status: Active
  • Modifier TC rule: A Technical Component (TC) modifier does not typically apply to anesthesia codes.
  • Fee Schedule : Historical fee schedule data is available from various sources, such as the CMS website.However, fee schedules change frequently and should be checked regularly.
  • Specialties:Anesthesiology, Gastroenterology
  • Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Office-based Surgery Center
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