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12465 Results

Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord

Service Code
01937 (CPT) Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord

Service Code
01938 (CPT) Anesthesia for percutaneous image-guided injection, drainage or aspiration procedures on the spine or spinal cord
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord

Service Code
01939 (CPT) Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord

Service Code
01940 (CPT) Anesthesia for percutaneous image-guided destruction procedures by neurolytic agent on the spine or spinal cord
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord

Service Code
01941 (CPT) Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord

Service Code
01942 (CPT) Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures Anesthesia for percutaneous image-guided neuromodulation or intravertebral procedures (eg, kyphoplasty, vertebroplasty) on the spine or spinal cord
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; less than 4% total body surface area

Service Code
01951 (CPT) Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; less than 4% total body surface area
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; between 4% and 9% of total body surface area

Service Code
01952 (CPT) Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; between 4% and 9% of total body surface area
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (List separa

Service Code
01953 (CPT) Anesthesia for second- and third-degree burn excision or debridement with or without skin grafting, any site, for total body surface area (TBSA) treated during anesthesia and surgery; each additional 9% total body surface area or part thereof (List separa
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for external cephalic version procedure

Service Code
01958 (CPT) Anesthesia for external cephalic version procedure
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for vaginal delivery only

Service Code
01960 (CPT) Anesthesia for vaginal delivery only
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for cesarean delivery only

Service Code
01961 (CPT) Anesthesia for cesarean delivery only
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for urgent hysterectomy following delivery

Service Code
01962 (CPT) Anesthesia for urgent hysterectomy following delivery
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care

Service Code
01963 (CPT) Anesthesia for cesarean hysterectomy without any labor analgesia/anesthesia care
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

1E-2 Therapeutic and Non-therapeutic Abortions

Service Code
01965 (CPT) Anesthesia for incomplete or missed abortion procedures
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.

Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).

Limits

A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.

Place of Service

Inpatient, Outpatient Hospital, Office

How to Submit

N/A - No authorization is required

Resources

1E-2 Therapeutic and Non-therapeutic Abortions

Service Code
01966 (CPT) Anesthesia for induced abortion procedures
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

Therapeutic Abortion A therapeutic abortion is the termination of a pregnancy where fetal heart tones are present at the time of the abortive procedure. The termination of a pregnancy may be induced medically (prostaglandin suppositories, etc.) or surgically (dilation and curettage, etc.). This includes the delivery of a non-viable (incapable of living outside the uterus) but live fetus, if labor was augmented by pitocin drip, laminaria suppository, etc.

Non-Therapeutic Abortion A non-therapeutic abortion is any termination of a pregnancy where there has been no manual or surgical interruption of that pregnancy (missed, incomplete, spontaneous, etc.).

Limits

A non-therapeutic abortion is defined as termination of a pregnancy where there has been no manual or surgical interruption of the pregnancy, such as missed, incomplete, or spontaneous abortion. Medicaid covers non-therapeutic abortions when the procedure is medically necessary and provided in accordance with federal and state laws and regulations. Specific coverage for non-therapeutic abortion applies when the termination of pregnancy occurs without any manual or surgical interruption of that pregnancy, including missed, incomplete, and spontaneous abortions.

Place of Service

Inpatient, Outpatient Hospital, Office

How to Submit

N/A - No authorization is required

Resources

Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)

Service Code
01967 (CPT) Neuraxial labor analgesia/anesthesia for planned vaginal delivery (this includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)

Service Code
01968 (CPT) Anesthesia for cesarean delivery following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)

Service Code
01969 (CPT) Anesthesia for cesarean hysterectomy following neuraxial labor analgesia/anesthesia (List separately in addition to code for primary procedure performed)
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required

Physiological support for harvesting of organ(s) from brain-dead patient

Service Code
01990 (CPT) Physiological support for harvesting of organ(s) from brain-dead patient
Prior Authorization Required
No
Benefit Plan
Medicaid
Diagnosis Group
Physical Health

How to Submit

N/A - No authorization is required