CPT 00810
Anesthesia for a colonoscopy
The anesthesia code for a colonoscopy or other lower endoscopy. It is billed by the anesthesia provider, separately from the gastroenterologist and the facility. For a screening colonoscopy the code may carry modifier 33 or PT, which affects whether it is covered without cost sharing.
Where this line goes wrong
Screening should be free, including the anesthesia
Under the Affordable Care Act, anesthesia for a screening colonoscopy is part of the preventive service and most plans must cover it with no cost sharing, even if a polyp was removed. A bill for the anesthesia on a screening colonoscopy is the most common complaint about this code.
Time units
Anesthesia is billed in 15-minute units on top of the base units. A routine colonoscopy takes well under an hour. A large time count is worth checking against the anesthesia record.
Out of network anesthesia
The anesthesia group is often not in the same network as the facility. Federal surprise billing rules cover this situation for insured patients.
Want to know if this line is right on your own bill? Upload it to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute.
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- 1
If the colonoscopy was a screening, ask the insurer why the anesthesia was not covered as part of the preventive benefit and ask the provider to check the modifier.
- 2
Ask for the anesthesia record. It shows the anesthesia start and stop times, which should match the minutes billed.
- 3
Check the modifier on the anesthesia line: AA means an anesthesiologist did it personally, QK or QY means the anesthesiologist directed a nurse anesthetist, QZ means the nurse anesthetist worked alone. Two full-price bills for the same case (one AA, one QZ) is an error.
- 4
Compare the anesthesia bill with the hospital's 0370 line and the operating room times for the same date.
- 5
If you were out of network for the anesthesiologist at an in-network facility, the No Surprises Act limits what you can be billed to your in-network cost sharing.
The full walkthrough for this kind of bill: Your bill came in above the estimate.
Upload the bill to a free mediloop account. An automatic first look reads the charges and shows what looks worth questioning, usually in about a minute. If you want a specialist to dispute it for you, it is a flat $129, refunded in full if the bill isn't lowered by at least $129.
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Codes that travel with this one
People also ask
Should anesthesia for a screening colonoscopy cost me anything?
For most insured people, no. Federal guidance treats anesthesia as integral to the screening. If you were charged, ask the plan and the anesthesia group to recode and reprocess.
Why did I get a separate anesthesia bill?
Because the anesthesia provider is a separate business from the doctor and the facility. Three bills for one colonoscopy is normal; check each one.
Sources
- CMS, Medicare Claims Processing Manual, chapter 12, section 50 (anesthesia services)
- CMS, No Surprises Act, what patients can expect
This page explains a billing code in general terms. It is not a coding, legal or medical opinion about your bill, and the code descriptions are mediloop's own plain-English summaries, not the official CPT descriptors, which are owned by the American Medical Association. Whether a charge was correct depends on the record of your visit and your payer's rules.