{"id":170789,"date":"2026-07-31T13:14:05","date_gmt":"2026-07-31T13:14:05","guid":{"rendered":"https:\/\/pabau.com\/?p=170789"},"modified":"2026-08-17T11:40:33","modified_gmt":"2026-08-17T11:40:33","slug":"cpt-code-00918","status":"publish","type":"post","link":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/","title":{"rendered":"CPT Code 00918: Anesthesia for ureteral calculus removal"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 00918: Anesthesia for transurethral procedures with ureteral calculus removal\",\"description\":\"CPT code 00918 covers anesthesia for transurethral procedures including urethrocystoscopy with fragmentation, manipulation, and\/or removal of ureteral calculus (N20.1). This reference covers the 5 anesthesia base units, the reimbursement formula, modifiers, Medicare rates, the ICD-10 crosswalk, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00918\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-01-28\",\"dateModified\":\"2026-07-31\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT code 00918 reports anesthesia for transurethral procedures with fragmentation, manipulation, or removal of a ureteral calculus.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>The code carries 5 anesthesia base units, not the 10 that some secondary coding references still repeat.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Payment equals base units plus time units, multiplied by the payer&#8217;s conversion factor.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Modifier AA applies when an anesthesiologist performs the service personally, and a CRNA billing without medical direction uses QZ.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau captures time units, prompts for modifiers, and validates ICD-10 pairings before submission.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">Transurethral stone removal is one of the most common urologic procedures billed under anesthesia. Claims for CPT code 00918 still land in denial queues, usually over modifier mismatches, thin time documentation, or a missing ICD-10 pairing.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Coding this code correctly takes more than the base unit value. You also need the anesthesia payment formula, the modifier that matches your provider arrangement, and the record payers expect to find.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reference covers the official description, the correct base unit value, and the reimbursement formula with a worked example. It also covers Medicare locality rates, every applicable modifier, the ICD-10 crosswalk, documentation requirements, and the denials that hit this code most often.<\/p>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div>\n<\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">CPT code 00918: official description and clinical scope<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 00918 covers anesthesia for transurethral procedures, specifically urethrocystoscopy with fragmentation, manipulation, and\/or removal of a ureteral calculus. The full official description is maintained by the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">American Medical Association (AMA)<\/a>. It reads: <em>Anesthesia for transurethral procedures (including urethrocystoscopy); with fragmentation, manipulation and\/or removal of ureteral calculus.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The code sits in the anesthesia section of the CPT code set, which runs from 00100 to 01999. It applies when the urologist performs a urethrocystoscopy to locate, fragment, and extract a ureteral stone. A separate anesthesia provider must administer general, regional, or monitored anesthesia care during that procedure.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">00918<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code category<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for procedures on the urinary tract<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Procedure covered<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Urethrocystoscopy with fragmentation, manipulation, and\/or removal of ureteral calculus<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Anesthesia base units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code maintained by<\/td>\n<td style=\"padding:12px 16px;color:#374151\">American Medical Association (AMA)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Billable?<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Yes (with required anesthesia modifiers)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Anesthesia base units for CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT code 00918 carries 5 anesthesia base units. That value comes from the American Society of Anesthesiologists (ASA) Relative Value Guide, and it appears in the nationwide base unit files payers publish. Base units represent the complexity and risk of anesthesia for a procedure type, independent of how long the case runs.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A figure of 10 base units circulates in some secondary coding references, and it is wrong. No published base unit file assigns 10 to 00918, at any edition or effective year. The Veterans Affairs Community Care anesthesia base unit table, the Mississippi Medicaid schedule, and the North Carolina Medicaid anesthesiology file all list 5.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">No code in the transurethral anesthesia family carries 10 units either, which is the quickest way to spot the error. Code 00910 carries 3 units. Codes 00912, 00914, 00916, and 00918 each carry 5. Open and laparoscopic renal work under 00862 carries 7.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">If your billing system or fee schedule shows 10 for 00918, the value was entered by hand and every claim built on it is overstated.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">How anesthesia time units are calculated<\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Time units come from the anesthesia record rather than the operative report. Divide total anesthesia minutes by 15 to get time units, then apply the payer&#8217;s rounding rule to any partial block. Anesthesia time starts when the provider begins preparing the patient for induction. It ends when the provider hands the patient over to post-anesthesia care.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Always document the start and stop times of anesthesia on the anesthesia record. Time units are calculated from the recorded minutes, and missing or inconsistent timestamps are the single most common audit finding for anesthesia claims.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">How anesthesia reimbursement is calculated for CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia reimbursement does not follow the resource-based relative value scale (RBRVS) formula used for most CPT codes. CMS and most commercial payers apply the anesthesia-specific payment formula instead.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Payment = (Base Units + Time Units) x Conversion Factor<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Base units:<\/strong> 5 (fixed for CPT 00918)<\/li><li><strong>Time units:<\/strong> total anesthesia minutes divided by 15 (each 15-minute block equals 1 time unit)<\/li><li><strong>Conversion factor:<\/strong> set annually by CMS, while commercial conversion factors vary by contract<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Worked example.<\/strong> A urethrocystoscopy with ureteral calculus removal takes 45 minutes of anesthesia time. That produces 3 time units (45 \/ 15). Adding the 5 base units gives 8 total units. Multiply those 8 units by the applicable conversion factor to get the allowable payment before any modifier reductions. The <a href=\"https:\/\/fastrvu.com\/tools\/rvu-lookup\" target=\"_blank\" rel=\"nofollow noopener\">FastRVU 2026 RVU lookup tool<\/a> can help you confirm current conversion factor values by locality.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Some payers calculate time units in 10-minute increments rather than 15, so confirm the methodology before you submit. A mismatch between your billing system and the payer&#8217;s rule creates systematic underpayment that practices rarely catch until an audit. <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00918\/automate-claims-through-healthcode.webp\" alt=\"Automate claims through Healthcode\"\/><figcaption class=\"wp-element-caption\"><em>Pabau sends insurer claims straight from the treatment record, so anesthesia time units and modifiers reach the payer without a second data entry pass.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<p class=\"wp-block-paragraph\">The <a href=\"https:\/\/pabau.com\/blog\/best-medical-practice-management-software\/\">best medical practice management tools<\/a> capture start and stop times at the point of care, which anesthesia billing depends on.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Medicare payment for CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare calculates anesthesia payments using its own conversion factor, published annually with the Physician Fee Schedule update. That conversion factor applies nationally, but the resulting payment varies by locality because of Geographic Practice Cost Index (GPCI) adjustments. You can look up current rates with the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule search tool<\/a>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare pays anesthesia at 100% of the allowable when modifier AA is appended, meaning the anesthesiologist performed the service personally. Under medical direction (modifiers QK or QY), the anesthesiologist and CRNA share a combined amount that does not exceed a single anesthesiologist&#8217;s payment. Rates change with each CMS update, so always cite the fee schedule year alongside any figure.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payer type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Conversion factor basis<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key consideration<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicare<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CMS annual update + GPCI locality adjustment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cite the applicable fee schedule year; rates vary by MAC locality<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Medicaid<\/td>\n<td style=\"padding:12px 16px;color:#374151\">State-set conversion factor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies significantly by state; confirm with the state Medicaid fee schedule<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Commercial payers<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Contract-negotiated conversion factor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">May also vary the time-unit interval (10 vs. 15 minutes); confirm per contract<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<h2 class=\"wp-block-heading\">Applicable modifiers for CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia modifiers are not optional. CMS and most commercial payers require at least one anesthesia-specific modifier on every claim, and the wrong one brings a denial or a reduced payment. The modifier signals who performed the anesthesia and which supervision arrangement was in place.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payment impact<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia services personally performed by anesthesiologist<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of allowable (Medicare)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA performing anesthesia without physician medical direction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of allowable (CRNA bills independently)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QX<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA performing anesthesia with medical direction by a physician<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of allowable (paired with QK or QY from physician)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QK<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical direction by physician for 2-4 concurrent CRNA procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of allowable per procedure directed<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QY<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical direction by physician for one CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of allowable<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QS<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Monitored anesthesia care (MAC)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Used with AA, QX, or QZ to indicate MAC service type<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AD<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medical supervision by physician for more than 4 concurrent procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3 base units only (Medicare supervision limit)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">G8<\/td>\n<td style=\"padding:12px 16px;color:#374151\">MAC for deep complex, complicated, or markedly invasive surgical procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Full base unit allowable; used with qualifying cases<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">P1-P6<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Physical status modifiers (patient health classification)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">P3 adds 1 unit; P4 adds 2 units; P5 adds 3 units (varies by payer)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Commercial rules for CRNA billing differ from Medicare&#8217;s. Some payers require QZ even when a physician is present in the facility but not actively directing the case. Verify each payer&#8217;s modifier requirements before billing. <\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00918\/automated-communication-in-pabau.webp\" alt=\"Automated communication in Pabau\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s automated messages handle pre-op and post-op patient contact around a stone removal, so your billing team can focus on modifier and time-unit checks.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes in the transurethral anesthesia family<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Picking the wrong code in this family is a common source of downcoding by payers and audit flags by the OIG. The table below sets 00918 against its siblings, and against the open renal code it is sometimes mistaken for.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Base units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00910<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for transurethral procedures (including urethrocystoscopy); not otherwise specified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">3<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when the urethrocystoscopy involves no stone fragmentation or removal<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00912<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for transurethral procedures; transurethral resection of bladder tumor(s)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bladder tumor resection, not stone work<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00914<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for transurethral procedures; transurethral resection of prostate<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">TURP, including laser and bipolar variants<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00916<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for transurethral procedures; post-transurethral resection bleeding<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Return to the OR to control bleeding after a resection<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00918<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for transurethral procedures; with fragmentation, manipulation and\/or removal of ureteral calculus<\/td>\n<td style=\"padding:12px 16px;color:#374151\">5<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when the ureteral calculus is the clinical objective of the procedure<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00862<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for extraperitoneal procedures in lower abdomen, including urinary tract; renal procedures, including upper one-third of ureter, or donor nephrectomy<\/td>\n<td style=\"padding:12px 16px;color:#374151\">7<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Open or laparoscopic renal procedures, not transurethral approaches<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">One wording trap sits inside that table. The phrase &#8222;not otherwise specified&#8220; belongs to 00860, the sibling code for extraperitoneal lower abdominal procedures, and to 00910 within the transurethral group. It is not part of the 00862 description, so an internal cheat sheet that attaches it there will send renal cases to the wrong code.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The line between 00910 and CPT code 00918 is clinical, not administrative. If the operative report documents fragmentation, lithotripsy, basket extraction, or any active manipulation of a ureteral stone, 00918 applies. If the scope is diagnostic, or the stone is noted without intervention, 00910 is correct.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">See the <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC CPT code lookup<\/a> for the full hierarchy of this family. Our reference on CPT code 00912 covers the bladder tumor resection sibling.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">ICD-10 codes that pair with CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Payers require a diagnosis code that establishes medical necessity for the anesthesia service. For CPT code 00918, the relevant ICD-10-CM codes describe ureteral and kidney stone disease. The <a href=\"https:\/\/www.aapc.com\/codify\/icd-10-crosswalk.aspx\" target=\"_blank\" rel=\"nofollow noopener\">AAPC CPT-to-ICD-10 crosswalk<\/a> and individual payer policies specify which codes are accepted, so verify against the applicable Local Coverage Determination before billing.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Relevance<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N20.1<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Calculus of ureter (ureterolithiasis)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Primary pairing; most common medical necessity diagnosis for 00918<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N20.2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Calculus of kidney with calculus of ureter<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when both kidney and ureteral stones are documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N20.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Calculus of kidney (nephrolithiasis)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use when the stone is in the kidney but a transurethral approach is documented<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N20.9<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Urinary calculus, unspecified<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Use only when site specificity cannot be coded from documentation<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">N13.2<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Hydronephrosis with renal and ureteral calculous obstruction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Secondary diagnosis when obstruction is documented alongside calculus<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Code to the highest level of specificity the operative report and pre-operative workup support. Using N20.9 when the record clearly identifies a ureteral stone is an error that invites payer queries. Local Coverage Determinations for ureteral calculus procedures may accept additional diagnoses, so confirm against the applicable MAC policy before billing.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Documentation requirements for billing CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">A clean claim for CPT code 00918 needs documentation that satisfies both CMS and commercial payer requirements. A missing element exposes the claim to denial or to post-payment audit recovery. <\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Pre-anesthesia evaluation:<\/strong> performed and documented within 48 hours before the procedure, including ASA physical status classification (P1-P6) and patient health history<\/li><li><strong>Anesthesia start and stop times:<\/strong> recorded to the minute on the anesthesia record; these determine time units and are the most common audit target<\/li><li><strong>Anesthesia technique:<\/strong> general, regional, MAC, or other; it must match the modifier appended to the claim<\/li><li><strong>Provider identification:<\/strong> name, NPI, and role (anesthesiologist, CRNA, supervising physician) for every clinician involved in the case<\/li><li><strong>Supervision documentation:<\/strong> if QK, QY, or QX applies, the anesthesiologist&#8217;s record must show involvement in all seven TEFRA medical direction criteria<\/li><li><strong>Intraoperative monitoring data:<\/strong> continuous vital sign recordings that show active anesthesia management throughout the procedure<\/li><li><strong>Post-anesthesia evaluation:<\/strong> documented within 48 hours after the procedure, confirming recovery and discharge criteria<\/li><li><strong>Diagnosis linkage:<\/strong> the ICD-10-CM code on the claim must be supported by the pre-operative diagnosis in the urologist&#8217;s and anesthesiologist&#8217;s notes<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Structured digital medical forms that capture pre-anesthesia and post-anesthesia evaluation data in a consistent format make audit preparation much faster. When every required element sits inside a templated workflow, a missing entry surfaces before the patient leaves the facility.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Common billing errors and denial reasons for CPT code 00918<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denials for CPT code 00918 cluster around a predictable set of errors. Knowing which ones occur most often lets a billing team build targeted pre-submission edits instead of chasing rejections afterward.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Wrong code selection (00910 vs. 00918):<\/strong> billing 00910 when the operative report documents stone fragmentation and removal. Payers will downcode and pay 3 base units instead of 5.<\/li><li><strong>An inflated base unit value:<\/strong> billing 00918 as a 10-unit code. The claim overstates the allowable and invites recoupment, because the published value is 5.<\/li><li><strong>Missing or mismatched modifier:<\/strong> omitting the required anesthesia modifier, or appending AA when a CRNA performed the case without direction. Modifier errors are the leading cause of outright denials.<\/li><li><strong>Incomplete time documentation:<\/strong> anesthesia start and stop times left blank, illegible, or inconsistent with the claim. CMS requires time to be documented contemporaneously.<\/li><li><strong>ICD-10 specificity mismatch:<\/strong> billing N20.9 when the operative report clearly identifies a ureteral stone (N20.1). Payers audit code specificity and may deny or query the claim.<\/li><li><strong>TEFRA criteria not met for medical direction:<\/strong> using QK or QY without documenting all seven medical direction criteria for the case. This is a significant OIG audit target.<\/li><li><strong>Incorrect time unit calculation:<\/strong> applying a 15-minute interval to a payer that requires 10 minutes, or the reverse. The error compounds across your whole claims volume.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Reviewing billing compliance requirements for anesthesia practices helps, and so does a pre-submission scrubber that checks the modifier, time documentation, and ICD-10 specificity. A claim edit at submission costs seconds. A denied claim costs 10 to 30 days of revenue delay plus the rework.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Run a monthly denial report filtered by CPT code 00918. If modifier-related denials exceed 5% of claims volume for this code, audit your modifier selection workflow. The most common fix is adding a provider-type prompt that enforces the correct modifier based on the supervising arrangement documented at case close.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">How practice management software supports CPT code 00918 billing<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Static code references tell you what CPT code 00918 means. They do not help you bill it correctly across dozens of cases a week, which is where errors accumulate. Most practices still retype anesthesia times from a paper record into a billing screen, then hope the modifier matches what happened in the room.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau closes that handoff. Pabau&#8217;s claims management software builds anesthesia billing into the same workflow that produces the clinical record. Time-unit capture, modifier prompting by provider role, and ICD-10 pairing checks all happen where the documentation is written, so nothing is transcribed after the fact.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Time unit automation:<\/strong> calculates units from documented start and stop times using the payer&#8217;s interval, whether that is 10 or 15 minutes<\/li><li><strong>Modifier prompting:<\/strong> flags the required modifier from the documented provider type and supervision arrangement at case close<\/li><li><strong>ICD-10 crosswalk validation:<\/strong> checks that the diagnosis paired with 00918 sits on the accepted list before the claim leaves the practice<\/li><li><strong>Audit-ready records:<\/strong> stores pre-anesthesia, intraoperative, and post-anesthesia notes in a structured format that meets CMS documentation requirements<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">The outcome is a shorter path from case close to a paid claim. Bringing digital intake forms and claims workflows into one platform removes the handoff errors that appear when documentation and billing run on separate systems. Practices that pair structured clinical forms with a rules-based billing engine see their clean-claim rate climb and their days in AR fall.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00918\/customizable-consent-and-intake-forms.webp\" alt=\"Customizable consent and intake forms\"\/><figcaption class=\"wp-element-caption\"><em>Pabau&#8217;s customizable consent and intake forms capture pre-anesthesia evaluation data in a fixed format, so every 00918 claim has the record standing behind it.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00940\/\">CPT code 00940 \u2014 Anesthesia for vaginal procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00920\/\">CPT code 00920 \u2014 Anesthesia for male genitalia procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00921\/\">CPT Code 00921 \u2014 Vasectomy anesthesia<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00922\/\">CPT Code 00922 \u2014 Anesthesia for seminal vesicle procedures<\/a><\/li>\n<\/ul>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Reduce anesthesia billing denials with Pabau                <\/h3>\n\n                <p class=\"description\">\n                    Pabau&#8217;s claims management software captures time units, validates modifier selection, and links ICD-10 diagnoses to CPT codes before claims are submitted. See how it works for anesthesia and urology billing teams.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau claims management software dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Accurate billing for CPT code 00918 rests on three things. The base unit value is 5. The modifier has to match the actual provider and supervision arrangement. The ICD-10 code has to be specific enough to prove medical necessity.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Get the base unit value wrong and every claim for this code is wrong with it, in one direction or the other. Check the figure in your fee schedule against a published base unit file today, then fix the workflow that let a hand-entered number through.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The rest is workflow. Capture times as they happen, prompt for the modifier at case close, and validate the diagnosis pairing before submission. To see how Pabau handles those steps for anesthesia and urology billing teams, <a href=\"https:\/\/pabau.com\/book-demo\/\">book a demo<\/a>.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need to manage billing documentation across a multi-site practice?<\/strong> <a href=\"https:\/\/pabau.com\/features\/multi-location\/\" target=\"_blank\" rel=\"noopener\">Pabau&#8217;s multi-location management<\/a> centralizes clinical records and billing workflows across all sites from a single dashboard.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Looking to reduce admin time on pre-anesthesia evaluations?<\/strong> <a href=\"https:\/\/pabau.com\/features\/digital-forms\/\" target=\"_blank\" rel=\"noopener\">Digital forms<\/a> create structured, HIPAA-compliant pre-op and post-op evaluation records that feed straight into the billing workflow.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Billing the bladder tumor resection sibling of this code?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00912\/\" target=\"_blank\" rel=\"noopener\">CPT code 00912<\/a> covers base units, modifiers, and documentation for transurethral resection of bladder tumors.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Want the wider view of billing for procedural codes?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/practice-management\/\" target=\"_blank\" rel=\"noopener\">Practice management for procedural billing<\/a> covers the workflow touchpoints from scheduling through payment reconciliation.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1785497473336\"><h3 class=\"schema-faq-question\">What does CPT code 00918 cover?<\/h3> <p class=\"schema-faq-answer\">CPT code 00918 covers anesthesia for transurethral procedures including urethrocystoscopy with fragmentation, manipulation, and\/or removal of ureteral calculus. It applies when a separate anesthesia provider administers anesthesia during a urologic procedure targeting ureteral stone removal. The code carries 5 anesthesia base units.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473337\"><h3 class=\"schema-faq-question\">How many base units does CPT 00918 have?<\/h3> <p class=\"schema-faq-answer\">CPT 00918 has 5 anesthesia base units. The value comes from the ASA Relative Value Guide and appears in the nationwide base unit files payers publish. Add the time units derived from documented anesthesia minutes, then multiply the total by the applicable conversion factor.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473338\"><h3 class=\"schema-faq-question\">Is CPT 00918 5 or 10 base units?<\/h3> <p class=\"schema-faq-answer\">It is 5. A 10-unit figure circulates in some secondary coding references, but no published base unit file assigns 10 to this code. The Veterans Affairs Community Care table, Mississippi Medicaid, and North Carolina Medicaid all list 5 units for 00918.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473339\"><h3 class=\"schema-faq-question\">What is the difference between CPT 00910 and CPT 00918?<\/h3> <p class=\"schema-faq-answer\">CPT 00910 covers transurethral procedures that do not involve ureteral calculus removal and carries 3 base units. CPT 00918 applies when fragmentation, manipulation, or removal of a ureteral calculus is the objective, and it carries 5 base units. Billing 00910 for documented stone work underpays the case.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473340\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT code 00918?<\/h3> <p class=\"schema-faq-answer\">The required modifier depends on the provider arrangement. Use AA when an anesthesiologist performs the service personally. Use QZ for a CRNA without medical direction, and QX for a CRNA under physician direction, paired with QK or QY. Physical status modifiers P3 to P5 can add units, depending on payer policy.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473341\"><h3 class=\"schema-faq-question\">What ICD-10 codes pair with CPT 00918?<\/h3> <p class=\"schema-faq-answer\">The primary ICD-10-CM pairing is N20.1, calculus of ureter. N20.2 applies when both kidney and ureteral stones are documented. N20.0 covers a kidney calculus reached through a transurethral approach. Use N20.9, unspecified urinary calculus, only when the documentation will not support a site.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473342\"><h3 class=\"schema-faq-question\">How is Medicare anesthesia reimbursement calculated for CPT 00918?<\/h3> <p class=\"schema-faq-answer\">Medicare applies the formula (Base Units + Time Units) x Conversion Factor. For CPT 00918, base units are fixed at 5, and time units equal total anesthesia minutes divided by 15. A 45-minute case therefore comes to 8 units. The conversion factor is set annually by CMS and varies by MAC locality.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473343\"><h3 class=\"schema-faq-question\">What documentation is required to bill CPT 00918?<\/h3> <p class=\"schema-faq-answer\">You need a pre-anesthesia evaluation within 48 hours before surgery, anesthesia start and stop times recorded to the minute, and the anesthesia technique used. You also need provider identification and roles, intraoperative monitoring records, and a post-anesthesia evaluation. Medical direction claims additionally require documentation of all seven TEFRA criteria.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785497473344\"><h3 class=\"schema-faq-question\">Does Medicare cover CPT code 00918?<\/h3> <p class=\"schema-faq-answer\">Yes. Medicare covers CPT code 00918 when a supporting ICD-10-CM diagnosis such as N20.1 establishes medical necessity and the claim carries the appropriate anesthesia modifier. Payment follows the Medicare locality conversion factor and the GPCI adjustment for the practice&#8217;s geographic area.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Transurethral stone removal is one of the most common urologic procedures billed under anesthesia. Claims for CPT code 00918 still land in denial queues, usually over modifier mismatches, thin time documentation, or a missing ICD-10 pairing. Coding this code correctly takes more than the base unit value. You also need the anesthesia payment formula, the [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":170788,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"","_yoast_wpseo_content_score":"90","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"[\"\",\"\",\"\",\"\",\"\"]","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[],"class_list":["post-170789","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 00918: Anesthesia for ureteral calculus removal<\/title>\n<meta name=\"description\" content=\"Transurethral stone removal is one of the most common urologic procedures billed under anesthesia. Claims for CPT code 00918 still land in denial queues,\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/\" \/>\n<meta property=\"og:locale\" content=\"de_DE\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT Code 00918: Anesthesia for ureteral calculus removal\" \/>\n<meta property=\"og:description\" content=\"Transurethral stone removal is one of the most common urologic procedures billed under anesthesia. Claims for CPT code 00918 still land in denial queues,\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" \/>\n<meta property=\"article:published_time\" content=\"2026-07-31T13:14:05+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2026-08-17T11:40:33+00:00\" \/>\n<meta property=\"og:image\" content=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/07\/cpt-code-00918.webp\" \/>\n\t<meta property=\"og:image:width\" content=\"1200\" \/>\n\t<meta property=\"og:image:height\" content=\"630\" \/>\n\t<meta property=\"og:image:type\" content=\"image\/webp\" \/>\n<meta name=\"author\" content=\"Aleksandar Kochovski\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:site\" content=\"@pabaucrm\" \/>\n<meta name=\"twitter:label1\" content=\"Verfasst von\" \/>\n\t<meta name=\"twitter:data1\" content=\"Aleksandar Kochovski\" \/>\n\t<meta name=\"twitter:label2\" content=\"Gesch\u00e4tzte Lesezeit\" \/>\n\t<meta name=\"twitter:data2\" content=\"1\u00a0Minute\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/\"},\"author\":{\"name\":\"Aleksandar Kochovski\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/73b672a49e20bfba8161e3c17ee3dda2\"},\"headline\":\"CPT Code 00918: Anesthesia for ureteral calculus removal\",\"datePublished\":\"2026-07-31T13:14:05+00:00\",\"dateModified\":\"2026-08-17T11:40:33+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/\"},\"wordCount\":2953,\"publisher\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#organization\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cpt-code-00918.webp\",\"articleSection\":[\"Billing Codes\",\"CPT Codes\"],\"inLanguage\":\"de\"},{\"@type\":[\"WebPage\",\"FAQPage\"],\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/\",\"name\":\"CPT Code 00918: Anesthesia for ureteral calculus removal\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#primaryimage\"},\"image\":{\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#primaryimage\"},\"thumbnailUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/07\\\/cpt-code-00918.webp\",\"datePublished\":\"2026-07-31T13:14:05+00:00\",\"dateModified\":\"2026-08-17T11:40:33+00:00\",\"description\":\"Transurethral stone removal is one of the most common urologic procedures billed under anesthesia. 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It combines scheduling, electronic health records, clinical forms, payments, marketing automation, reporting, and patient engagement tools into one secure cloud system to help practices streamline operations and grow their business.\",\"foundingDate\":\"2011-10-20\",\"numberOfEmployees\":{\"@type\":\"QuantitativeValue\",\"minValue\":\"201\",\"maxValue\":\"500\"}},{\"@type\":\"Person\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/#\\\/schema\\\/person\\\/73b672a49e20bfba8161e3c17ee3dda2\",\"name\":\"Aleksandar Kochovski\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"de\",\"@id\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"url\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"contentUrl\":\"https:\\\/\\\/pabau.com\\\/wp-content\\\/uploads\\\/2026\\\/06\\\/cropped-aleksandar-kochovski-profile-picture-96x96.jpeg\",\"caption\":\"Aleksandar Kochovski\"},\"description\":\"Aleksandar is a content strategist and editor working in tech publishing, with a background in higher education. He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.\",\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/blog\\\/author\\\/aleksandar-kochovski\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473336\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473336\",\"name\":\"What does CPT code 00918 cover?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT code 00918 covers anesthesia for transurethral procedures including urethrocystoscopy with fragmentation, manipulation, and\\\/or removal of ureteral calculus. It applies when a separate anesthesia provider administers anesthesia during a urologic procedure targeting ureteral stone removal. The code carries 5 anesthesia base units.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473337\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473337\",\"name\":\"How many base units does CPT 00918 have?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 00918 has 5 anesthesia base units. The value comes from the ASA Relative Value Guide and appears in the nationwide base unit files payers publish. Add the time units derived from documented anesthesia minutes, then multiply the total by the applicable conversion factor.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473338\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473338\",\"name\":\"Is CPT 00918 5 or 10 base units?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"It is 5. A 10-unit figure circulates in some secondary coding references, but no published base unit file assigns 10 to this code. The Veterans Affairs Community Care table, Mississippi Medicaid, and North Carolina Medicaid all list 5 units for 00918.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473339\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473339\",\"name\":\"What is the difference between CPT 00910 and CPT 00918?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 00910 covers transurethral procedures that do not involve ureteral calculus removal and carries 3 base units. CPT 00918 applies when fragmentation, manipulation, or removal of a ureteral calculus is the objective, and it carries 5 base units. Billing 00910 for documented stone work underpays the case.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473340\",\"position\":5,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473340\",\"name\":\"What modifiers apply to CPT code 00918?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The required modifier depends on the provider arrangement. Use AA when an anesthesiologist performs the service personally. Use QZ for a CRNA without medical direction, and QX for a CRNA under physician direction, paired with QK or QY. Physical status modifiers P3 to P5 can add units, depending on payer policy.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473341\",\"position\":6,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473341\",\"name\":\"What ICD-10 codes pair with CPT 00918?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The primary ICD-10-CM pairing is N20.1, calculus of ureter. N20.2 applies when both kidney and ureteral stones are documented. N20.0 covers a kidney calculus reached through a transurethral approach. Use N20.9, unspecified urinary calculus, only when the documentation will not support a site.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473342\",\"position\":7,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473342\",\"name\":\"How is Medicare anesthesia reimbursement calculated for CPT 00918?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Medicare applies the formula (Base Units + Time Units) x Conversion Factor. For CPT 00918, base units are fixed at 5, and time units equal total anesthesia minutes divided by 15. A 45-minute case therefore comes to 8 units. The conversion factor is set annually by CMS and varies by MAC locality.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473343\",\"position\":8,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473343\",\"name\":\"What documentation is required to bill CPT 00918?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"You need a pre-anesthesia evaluation within 48 hours before surgery, anesthesia start and stop times recorded to the minute, and the anesthesia technique used. You also need provider identification and roles, intraoperative monitoring records, and a post-anesthesia evaluation. Medical direction claims additionally require documentation of all seven TEFRA criteria.\",\"inLanguage\":\"de\"},\"inLanguage\":\"de\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473344\",\"position\":9,\"url\":\"https:\\\/\\\/pabau.com\\\/de\\\/procedure-codes\\\/cpt-code-00918\\\/#faq-question-1785497473344\",\"name\":\"Does Medicare cover CPT code 00918?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"Yes. Medicare covers CPT code 00918 when a supporting ICD-10-CM diagnosis such as N20.1 establishes medical necessity and the claim carries the appropriate anesthesia modifier. 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He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.","url":"https:\/\/pabau.com\/de\/blog\/author\/aleksandar-kochovski\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473336","position":1,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473336","name":"What does CPT code 00918 cover?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT code 00918 covers anesthesia for transurethral procedures including urethrocystoscopy with fragmentation, manipulation, and\/or removal of ureteral calculus. It applies when a separate anesthesia provider administers anesthesia during a urologic procedure targeting ureteral stone removal. The code carries 5 anesthesia base units.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473337","position":2,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473337","name":"How many base units does CPT 00918 have?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 00918 has 5 anesthesia base units. The value comes from the ASA Relative Value Guide and appears in the nationwide base unit files payers publish. Add the time units derived from documented anesthesia minutes, then multiply the total by the applicable conversion factor.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473338","position":3,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473338","name":"Is CPT 00918 5 or 10 base units?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"It is 5. A 10-unit figure circulates in some secondary coding references, but no published base unit file assigns 10 to this code. The Veterans Affairs Community Care table, Mississippi Medicaid, and North Carolina Medicaid all list 5 units for 00918.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473339","position":4,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473339","name":"What is the difference between CPT 00910 and CPT 00918?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 00910 covers transurethral procedures that do not involve ureteral calculus removal and carries 3 base units. CPT 00918 applies when fragmentation, manipulation, or removal of a ureteral calculus is the objective, and it carries 5 base units. Billing 00910 for documented stone work underpays the case.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473340","position":5,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473340","name":"What modifiers apply to CPT code 00918?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The required modifier depends on the provider arrangement. Use AA when an anesthesiologist performs the service personally. Use QZ for a CRNA without medical direction, and QX for a CRNA under physician direction, paired with QK or QY. Physical status modifiers P3 to P5 can add units, depending on payer policy.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473341","position":6,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473341","name":"What ICD-10 codes pair with CPT 00918?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The primary ICD-10-CM pairing is N20.1, calculus of ureter. N20.2 applies when both kidney and ureteral stones are documented. N20.0 covers a kidney calculus reached through a transurethral approach. Use N20.9, unspecified urinary calculus, only when the documentation will not support a site.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473342","position":7,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473342","name":"How is Medicare anesthesia reimbursement calculated for CPT 00918?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Medicare applies the formula (Base Units + Time Units) x Conversion Factor. For CPT 00918, base units are fixed at 5, and time units equal total anesthesia minutes divided by 15. A 45-minute case therefore comes to 8 units. The conversion factor is set annually by CMS and varies by MAC locality.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473343","position":8,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473343","name":"What documentation is required to bill CPT 00918?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"You need a pre-anesthesia evaluation within 48 hours before surgery, anesthesia start and stop times recorded to the minute, and the anesthesia technique used. You also need provider identification and roles, intraoperative monitoring records, and a post-anesthesia evaluation. Medical direction claims additionally require documentation of all seven TEFRA criteria.","inLanguage":"de"},"inLanguage":"de"},{"@type":"Question","@id":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473344","position":9,"url":"https:\/\/pabau.com\/de\/procedure-codes\/cpt-code-00918\/#faq-question-1785497473344","name":"Does Medicare cover CPT code 00918?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. Medicare covers CPT code 00918 when a supporting ICD-10-CM diagnosis such as N20.1 establishes medical necessity and the claim carries the appropriate anesthesia modifier. Payment follows the Medicare locality conversion factor and the GPCI adjustment for the practice's geographic area.","inLanguage":"de"},"inLanguage":"de"}]}},"yoast":{"focus_keyword":"CPT code 00918","seo_title":"CPT Code 00918: Anesthesia for ureteral calculus removal","meta_description":"","content_score":"90","is_cornerstone":"","related_keyphrases":[{"keyword":"anesthesia base units","score":61},{"keyword":"transurethral anesthesia CPT","score":61},{"keyword":"ureteral calculus anesthesia code","score":61},{"keyword":"anesthesia billing documentation","score":61}]},"_links":{"self":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/170789","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/users\/81"}],"replies":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/comments?post=170789"}],"version-history":[{"count":4,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/170789\/revisions"}],"predecessor-version":[{"id":181735,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/posts\/170789\/revisions\/181735"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media\/170788"}],"wp:attachment":[{"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/media?parent=170789"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/categories?post=170789"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/pabau.com\/de\/wp-json\/wp\/v2\/tags?post=170789"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}