How To Use CPT Code 00670

cpt 00670 describes anesthesia services for extensive spine and spinal cord procedures, such as spinal instrumentation or vascular procedures. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 00670.

1. What is cpt 00670?

cpt 00670 is a code used to describe anesthesia services provided during extensive spine and spinal cord procedures. These procedures may include spinal instrumentation, where plates and screws are implanted into the spine to stabilize it, as well as vascular procedures on blood vessels in the spine and spinal cord.

2. Official Description

The official description of cpt 00670 is: ‘Anesthesia for extensive spine and spinal cord procedures (eg, spinal instrumentation or vascular procedures).’ This code represents the anesthesia services provided during these specific procedures.

3. Procedure

During an extensive spine and spinal cord procedure, the anesthesia provider performs a pre-operative evaluation of the patient. They then induce the patient and monitor them throughout the procedure, which is performed by a different provider. The anesthesia provider administers medications, monitors the patient’s vital signs, and ensures their comfort and safety during the procedure. After the procedure, the anesthesia provider oversees the patient’s transfer to the post-anesthesia care unit.

4. Qualifying circumstances

cpt 00670 is used for anesthesia services during extensive spine and spinal cord procedures. These procedures typically involve complex surgical interventions, such as spinal instrumentation or vascular procedures. The anesthesia provider must be present throughout the procedure and ensure the patient’s safety and comfort. Qualifying circumstances may include extreme age (younger than 1 year or older than 70), utilization of total body hypothermia, utilization of controlled hypotension, or emergency conditions.

5. When to use cpt code 00670

cpt 00670 should be used when anesthesia services are provided during extensive spine and spinal cord procedures, such as spinal instrumentation or vascular procedures. It is important to ensure that the procedure meets the criteria for extensive spine and spinal cord procedures and that the anesthesia provider is present throughout the procedure.

6. Documentation requirements

To support a claim for cpt 00670, the anesthesia provider must document the following information:

• Pre-operative evaluation of the patient
• Medications administered during the procedure
• Monitoring used during the procedure
• Patient responses and vital signs
• Start and stop times of anesthesia care
• Transfer of the patient to the post-anesthesia care unit

7. Billing guidelines

When billing for cpt 00670, ensure that the anesthesia provider is present throughout the extensive spine and spinal cord procedure. It is important to follow the specific billing guidelines of the payer, including the use of appropriate modifiers and documentation requirements. If multiple anesthesia services are provided during the same encounter, assign the most complex anesthesia procedure code with the highest base unit value. Add the anesthesia time for all procedures combined and divide it by the time unit increment used by the payer to determine the total units to bill on the claim form.

8. Historical information

cpt 00670 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone historical changes, including a code change in 2001 to specify the use of Harrington rod technique and being added to the Inpatient Only (IPO) list by Medicare in 2017. However, it was removed from the IPO list in 2019.

9. Similar codes to cpt 00670

Five similar codes to cpt 00670 include:

• cpt 00600: Anesthesia for procedures on the spine and spinal cord, not otherwise specified
• cpt 00620: Anesthesia for procedures on the spine and spinal cord, not otherwise specified, except for spinal fusion
• cpt 00625: Anesthesia for procedures on the spine and spinal cord, not otherwise specified, except for spinal fusion, with laminectomy
• cpt 00630: Anesthesia for procedures on the spine and spinal cord, not otherwise specified, except for spinal fusion, with laminotomy
• cpt 00635: Anesthesia for procedures on the spine and spinal cord, not otherwise specified, except for spinal fusion, with laminoplasty

9. Examples

1. An anesthesia provider administering anesthesia during a spinal instrumentation procedure for a patient with severe scoliosis.
2. An anesthesia provider monitoring a patient’s vital signs during a vascular procedure on the blood vessels of the spinal cord.
3. An anesthesia provider ensuring the patient’s comfort and safety during a complex spinal fusion procedure.
4. An anesthesia provider administering medications and monitoring a patient during a spinal cord tumor resection.
5. An anesthesia provider overseeing the patient’s transfer to the post-anesthesia care unit after a spinal decompression procedure.
6. An anesthesia provider managing the patient’s anesthesia during a spinal cord stimulator implantation.
7. An anesthesia provider monitoring the patient’s oxygen levels during a spinal cord biopsy.
8. An anesthesia provider administering fluids and medications during a spinal cord vascular malformation repair.
9. An anesthesia provider ensuring the patient’s comfort and safety during a spinal cord trauma surgery.
10. An anesthesia provider monitoring the patient’s blood pressure during a spinal cord aneurysm repair.