CPT Code 00812: Anesthesia for Lower GI Endoscopy, Moderate Complexity

Learn how CPT code 00812 applies to anesthesia for moderate-complexity lower GI endoscopic procedures with the endoscope introduced distal to the splenic flexure.

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Table of content

What is anesthesia for moderate complexity lower GI endoscopy?CPT code 00812 documentation requirements CPT code 00812 billing guidelines Other relevant CPT codes

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What is anesthesia for moderate complexity lower GI endoscopy?

CPT code 00812 refers to anesthesia for lower intestinal endoscopic procedures that involve moderate complexity, such as a screening colonoscopy with biopsy, snare polypectomy, or balloon dilation. These endoscopic procedures require that the endoscope be introduced distal to the splenic flexure and are typically performed in outpatient or ambulatory surgical settings.

The code covers all phases of anesthesia care—including pre-induction, maintenance, emergence, and post-procedure monitoring—ensuring comfort and safety as the patient undergoes a procedure involving the lower gastrointestinal tract.

CPT code 00812 supports accurate billing for cases where anesthesia for lower intestinal procedures is essential due to the procedure’s duration, complexity, or patient condition.

CPT code 00812 documentation requirements

To ensure compliance and accurate billing, the following documentation is required when reporting CPT 00812:

Pre-anesthetic assessment, including ASA physical status classification
Start and end times of the anesthesia service
Type of lower intestinal endoscopic procedure performed (e.g., colonoscopy with polyp removal)
Anesthesia technique used (e.g., MAC or general anesthesia)
Continuous monitoring of vital signs and oxygenation
Detailed post-anesthesia condition report
Linkage to the associated surgical CPT code (e.g., 45385 for colonoscopy with polypectomy)

CPT code 00812 billing guidelines

When billing for CPT 00812, follow these key coding rules:

Report base units: 3
Document time in 15-minute increments
Append appropriate provider role modifiers (e.g., -AA for personally performed, -QK for medical direction)
Do not report CPT 00812 if the proceduralist also provides anesthesia—this would fall under moderate sedation codes
Use physical status modifiers (P1–P6) as appropriate to reflect the patient’s health condition
CPT 00812 may be reported for both diagnostic and therapeutic intestinal endoscopic procedures where the endoscope is introduced distal to the splenic flexure

To ensure accurate billing, providers must include anesthesia start/end times, the nature of the procedure, physical status modifiers, and confirm that the intestinal endoscopic procedure's endoscope introduction meets the criteria for 00812. Use anesthesia modifiers appropriately and include any additional information required by payers.

Other relevant CPT codes

00810: Anesthesia for sigmoidoscopy (less extensive than CPT 00812)
99152: Moderate sedation by the same provider performing the procedure
45385: Colonoscopy with removal of polyp(s) using snare technique (often linked with 00812)

Frequently asked questions

What does CPT code 00812 cover?

00812 CPT is used for anesthesia services during intestinal endoscopic procedures where the endoscope is introduced distal to the splenic flexure, typically in moderate- to high-complexity procedures, such as screening colonoscopies or polyp removal.

When is CPT 00812 appropriate for endoscopic procedures?

Use 00812 CPT when endoscopic procedures are performed, such as during a diagnostic or therapeutic colonoscopy, where the endoscope is introduced distally. This applies only to procedures where the endoscope is introduced distal to the splenic flexure.

Is CPT 00812 reimbursable for Medicare beneficiaries?

Yes, Medicare beneficiaries may qualify for reimbursement under CPT code 00812, provided the service is medically necessary and properly documented. Confirm with your MAC for specific billing policies under Medicare.