How To Use CPT Code 00218

cpt 00218 describes anesthesia services for intracranial procedures performed with the patient in a sitting position. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 00218.

1. What is cpt 00218?

cpt 00218 is used to describe anesthesia services provided to a patient undergoing an intracranial procedure while in a sitting position. The anesthesia provider performs a pre-operative evaluation of the patient, induces anesthesia, and monitors the patient during the procedure. They also note the medications administered, types of monitoring used, patient responses, and the start and stop times of anesthesia care. After the procedure, the anesthesia provider oversees the patient’s transfer to post-anesthesia care.

2. Official Description

The official description of cpt 00218 is: ‘Anesthesia for intracranial procedures; procedures in sitting position.’

3. Procedure

The anesthesia provider begins by performing a pre-operative evaluation of the patient. They then induce anesthesia and monitor the patient during the intracranial procedure, which is performed with the patient in a sitting position. The anesthesia provider administers medications as necessary and utilizes standard monitoring services such as ECG, temperature, blood pressure, oximetry, capnography, and mass spectrometry. They document the start and stop times of anesthesia care and oversee the patient’s transfer to post-anesthesia care.

4. Qualifying circumstances

cpt 00218 is used for patients undergoing intracranial procedures while in a sitting position. The anesthesia provider must perform a pre-operative evaluation, induce anesthesia, and monitor the patient during the procedure. The anesthesia services may include the administration of fluids and/or blood, as well as standard monitoring services. Unusual forms of monitoring, such as the use of Swan-Ganz catheters or central venous lines, may be coded separately if sufficient documentation is available.

5. When to use cpt code 00218

cpt 00218 should be used when providing anesthesia services for intracranial procedures performed with the patient in a sitting position. It is important to ensure that the anesthesia provider performs a pre-operative evaluation, induces anesthesia, and monitors the patient during the procedure. Standard monitoring services should be utilized, and any unusual forms of monitoring should be coded separately if documented appropriately.

6. Documentation requirements

To support a claim for cpt 00218, the anesthesia provider must document the following information:

• Pre-operative evaluation of the patient
• Medications administered during anesthesia
• Types of monitoring used
• Patient responses during anesthesia
• Start and stop times of anesthesia care
• Transfer of the patient to post-anesthesia care

7. Billing guidelines

When billing for cpt 00218, ensure that the anesthesia provider performs a pre-operative evaluation, induces anesthesia, and monitors the patient during the intracranial procedure. Standard monitoring services should be utilized, and any unusual forms of monitoring should be coded separately if documented appropriately. It is important to follow the specific billing guidelines of the payer, including the use of modifiers and reporting of anesthesia time.

8. Historical information

cpt 00218 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Similar codes to cpt 00218

Five similar codes to cpt 00218 include:

• cpt 00216: Anesthesia for procedures on the skull and face; not otherwise specified
• cpt 00220: Anesthesia for procedures on the skull involving cranial osteoplasty
• cpt 00222: Anesthesia for procedures on the skull and face; complicated
• cpt 00300: Anesthesia for procedures on the nose and accessory sinuses; diagnostic or therapeutic
• cpt 00320: Anesthesia for procedures on the nose and accessory sinuses; complicated

9. Examples

1. An anesthesia provider performing anesthesia services for a patient undergoing a craniotomy while in a sitting position.
2. An anesthesia provider administering anesthesia to a patient undergoing a transsphenoidal pituitary tumor resection in a sitting position.
3. An anesthesia provider monitoring a patient during an endoscopic third ventriculostomy performed with the patient in a sitting position.
4. An anesthesia provider providing anesthesia services for a patient undergoing a cerebrospinal fluid shunt placement while in a sitting position.
5. An anesthesia provider inducing anesthesia and monitoring a patient during a posterior fossa decompression performed with the patient in a sitting position.
6. An anesthesia provider overseeing the transfer of a patient to post-anesthesia care following an intracranial procedure performed with the patient in a sitting position.
7. An anesthesia provider documenting the start and stop times of anesthesia care during an intracranial procedure performed with the patient in a sitting position.
8. An anesthesia provider administering fluids and monitoring a patient’s vital signs during an intracranial procedure performed with the patient in a sitting position.
9. An anesthesia provider utilizing standard monitoring services, such as ECG and oximetry, during an intracranial procedure performed with the patient in a sitting position.
10. An anesthesia provider documenting the patient’s response to anesthesia and the administration of medications during an intracranial procedure performed with the patient in a sitting position.