CPT code 01190: Deleted pelvic anesthesia code and replacements

Key Takeaways

CPT code 01190 described anesthesia for procedures on the pelvis (except hip) and was deleted from the CPT code set effective January 1, 2018.

Claims submitted with CPT 01190 today will be denied as a non-covered or invalid code by Medicare and most commercial payers.

Billing teams encountering 01190 in legacy records should crosswalk to the active pelvic anesthesia codes in the 01112-01180 range based on the specific procedure performed.

Pabau’s claims management software helps anesthesia and surgical practices track active codes, flag deleted codes, and reduce claim denials before submission.

CPT code 01190: Definition, deletion, and what replaced it

Claims submitted with CPT Code 01190 after January 1, 2018 return a denial. That is the single most important fact billing teams and anesthesiologists need to know about this code. Yet it keeps appearing in legacy records, audit trails, and payer correspondence, which is why understanding its history, its deletion, and its replacement codes still matters for active practices.

CPT Code 01190 described anesthesia services provided during surgical procedures on the pelvis, excluding procedures on the hip. Maintained by the American Medical Association (AMA) through the CPT Editorial Panel, this code sat within the broader anesthesia range of 00100 to 01999 and was specifically used by anesthesiologists and Certified Registered Nurse Anesthetists (CRNAs) to document anesthesia care during pelvic surgeries, including pelvic nerve removal procedures. It has been inactive for over seven years.

When was CPT code 01190 deleted?

The AMA’s CPT Editorial Panel deleted CPT Code 01190 effective January 1, 2018, as confirmed by the AAPC Codify deleted code registry. The deletion was part of a broader revision to the pelvic anesthesia code set, restructuring how pelvic procedure anesthesia is reported to better align with current surgical practice patterns.

From that date forward, 01190 became a non-payable code. Massachusetts Health Safety Net lists it explicitly on its non-payable service codes list (updated January 1, 2025), and Medicare through Noridian Medicare (JE Part B MAC) no longer recognises it as a billable anesthesia service. Any claim submitted with 01190 after the deletion date will be rejected or denied by payers.

Why deletions matter for billing staff

Deleted CPT codes do not disappear from electronic health records, old superbills, or practice management templates. Billing staff at practices that perform pelvic surgeries may still encounter 01190 in charge capture screens, historical encounter data, or denial letters referencing old submissions. Knowing the deletion date and the correct replacement codes prevents avoidable rework.

CPT code 01190 description: what it covered

The official description for CPT Code 01190 was “Anesthesia for procedures on the pelvis (except hip).” More specifically, sources including MDClarity describe its use for anesthesia provided during the surgical removal of a pelvic nerve (neurectomy). The code applied to:

• General anesthesia administered during open or laparoscopic pelvic procedures
• Anesthesia for pelvic neurectomy (nerve removal)
• Anesthesia for other surgical interventions within the pelvic region, explicitly excluding the hip joint

The hip exclusion was deliberate. Procedures on the hip joint have their own dedicated anesthesia codes within the CPT system, so 01190 was scoped to the pelvic cavity and adjacent structures only. This distinction matters when crosswalking to replacement codes, because the hip exclusion is preserved in the current active code set.

CPT code 01190 replacement codes: The crosswalk

The replacement codes for CPT 01190 fall within the active pelvic anesthesia range. According to Noridian Medicare’s anesthesia and pain management specialty page, the current active pelvic anesthesia CPT code range runs from 01112 to 01180. Billing teams crosswalking from 01190 should identify the correct replacement by matching the specific surgical procedure to the most precise code description.

The table below maps the active pelvic anesthesia codes most likely to replace 01190 in current billing workflows. Also see related specialty codes such as IVF CPT codes for procedures involving the reproductive organs of the pelvis.

For practices managing pelvic surgery anesthesia billing, using the AAPC Codify CPT lookup tool to verify the current descriptor and confirm the active status of any replacement code before submission is strongly recommended. Verify against current AMA CPT code books, as code descriptions and active status change with each annual update.

Anesthesia billing for pelvic procedures: Modifiers and base units

Anesthesia billing does not follow the same structure as surgical CPT billing. Rather than a flat fee per procedure, anesthesia reimbursement is calculated using a formula: (Base Units + Time Units + Qualifying Circumstances Units) x Anesthesia Conversion Factor. Understanding this formula is essential for practices billing any active pelvic anesthesia code that replaced CPT 01190.

Base units are assigned by the AMA for each anesthesia CPT code and reflect the relative complexity of providing anesthesia for that type of procedure. Time units are calculated as one unit per 15 minutes of anesthesia time (though payer policies on time unit intervals vary). The CMS Physician Fee Schedule lookup tool is the authoritative source for current Medicare anesthesia conversion factors, which are updated annually. For 2026 conversion factors, check the CMS Anesthesiologists Center directly, as rates change each fiscal year.

Required anesthesia modifiers

Anesthesia claims require specific modifiers to indicate the provider type and supervision arrangement. Omitting or misapplying these modifiers is a leading cause of anesthesia claim denials. The table below summarises the most commonly required modifiers for pelvic anesthesia billing.

Payer-specific modifier rules may differ from Medicare policy. Always confirm modifier requirements with each contracted payer before submitting claims. For practices managing anesthesia billing across a surgical specialty setting, a robust documentation workflow is essential to capture the correct modifier at the time of service.

Documentation requirements for pelvic anesthesia billing

Whether billing 01120, 01173, 01180, or any other active code from the pelvic anesthesia range, the documentation standards are consistent. The anesthesia record must support the specific code billed. A claim for 01180 (obturator neurectomy anesthesia) requires documentation that an obturator neurectomy was the surgical procedure performed. Billing the wrong code because it “covers pelvic procedures generally” is a documentation mismatch that can trigger audits.

Key documentation elements for any anesthesia claim include:

• The surgical procedure performed (matched to the anesthesia CPT code description)
• Pre-anesthesia evaluation note confirming patient assessment
• Anesthesia start and end times (for time unit calculation)
• Provider identity and supervision arrangement (supporting the modifier used)
• Post-anesthesia care documentation

The National Correct Coding Initiative (NCCI) edits maintained by CMS govern bundling rules for anesthesia codes. Check the CMS coding and billing resources for current NCCI edit tables before submitting pelvic anesthesia claims, as bundling rules affect which codes can be billed together on the same date of service. Practices managing pelvic health anesthesia billing should also review the specific coverage and documentation requirements applicable to their pelvic health practice workflows.

HIPAA compliance and record retention

Legacy encounters billed with CPT 01190 before the 2018 deletion date remain part of the medical record and must be retained per applicable federal and state record retention requirements. Under the Health Insurance Portability and Accountability Act (HIPAA), covered entities must safeguard protected health information regardless of how old the underlying service was. For detailed compliance obligations, the Pabau guide to HIPAA compliance for medical offices covers the key safeguards anesthesia practices need to maintain.

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Medicare reimbursement for pelvic anesthesia codes

Medicare reimbursement for anesthesia is calculated differently from standard physician services. The formula (base units + time units) x conversion factor applies across all active anesthesia codes, including those now used in place of the deleted 01190. The anesthesia conversion factor is locality-specific and updated annually. For the most current 2026 anesthesia conversion factors, download the published ZIP file from the CMS Anesthesiologists Center.

A key difference between anesthesia billing and standard E/M or surgical billing: the Relative Value Unit (RVU) framework does not apply directly to anesthesia codes. Anesthesia uses base units and time units rather than work/practice expense/malpractice RVUs. Practices wanting to benchmark anesthesia reimbursement can use the FastRVU 2026 lookup tool for general RVU context, but anesthesia-specific reimbursement calculations require the CMS anesthesia conversion factor, not standard RVU data.

Payer-specific reimbursement rates for active pelvic anesthesia codes vary significantly. Medicare rates are publicly available through the CMS Physician Fee Schedule. Commercial payer rates are contract-specific. Medicaid rates differ by state, with some state programs (such as ForwardHealth in Wisconsin) publishing quarterly updated anesthesia code tables that may affect which codes are covered and at what rate.

Claim denials: common reasons when billing pelvic anesthesia

Beyond submitting a deleted code like 01190, the most common denial reasons for pelvic anesthesia claims include:

• Incorrect or missing anesthesia modifier (AA, QK, QX, QY, QZ, AD)
• Anesthesia time not documented or not matching the units billed
• Surgical code and anesthesia code combination not supported by NCCI edits
• Missing pre-anesthesia evaluation in the medical record
• Procedure not covered under the patient’s specific plan benefits

Practices billing for OB-GYN and pelvic surgery services benefit from a structured denial tracking workflow that flags recurring patterns. When the same code combination produces repeated denials, that is a signal to review both the clinical documentation and the modifier assignment protocol, not just resubmit the claim.

CPT code 01190 in legacy systems and audit contexts

Seven-plus years after deletion, CPT Code 01190 still surfaces in specific contexts: retrospective billing audits, RAC (Recovery Audit Contractor) reviews, payer recoupment requests, and coding compliance assessments. If an audit is reviewing encounters from 2017 or earlier, 01190 would have been a valid code at that time and should not be flagged as inappropriate for those dates of service.

The confusion arises when a post-2018 encounter carries 01190, either from a template that was never updated or from a charge entry error. In that scenario, the code was definitively invalid at the time of submission. The correct response is to identify the appropriate active replacement code from the 01112-01180 range, correct the claim, and resubmit with the accurate code. See related coding documentation practices in this ICD-10 code reference for how coding accuracy applies across both diagnostic and procedure code sets.

For practices running compliance programs, a useful starting reference is the ADHD screening CPT code guide, which covers similar crosswalk and documentation principles applicable to any specialty-specific CPT reference update. The same logic applies across specialties: code deletions require proactive template audits, not reactive claims corrections.

Practices that use electronic health records or practice management software should configure their systems to alert on inactive CPT codes. Some platforms auto-update code libraries; others require manual updates. Confirm with your vendor whether deleted codes like 01190 are suppressed from selection in the charge capture interface. Using a current procedure code fee schedule reference alongside your EHR helps catch gaps before they become denials. The same diligence applies when referencing other code types, such as IVF CPT codes, which also sit within specialty-specific pelvic and reproductive procedure coding.

Conclusion

CPT Code 01190 has been deleted since January 1, 2018. Any claim submitted with this code today will be denied. Billing teams and anesthesia practices should crosswalk to the active codes in the 01112-01180 pelvic anesthesia range, apply the correct supervision modifier, and ensure documentation supports the specific procedure code billed.

Pabau’s claims management software helps surgical and anesthesia practices reduce denials by supporting accurate code selection, modifier tracking, and documentation workflows from the point of care. To see how it works for your practice, book a demo.

Continue your research

Need a reference for related pelvic and reproductive procedure codes? IVF CPT codes covers billing guidance for fertility-related pelvic procedures including code selection and documentation requirements.

Billing for surgical specialties and want to reduce claim denials? Pabau claims management software supports anesthesia and surgical practices with streamlined code tracking and submission workflows.

Managing compliance across multiple procedure code types? Procedure codes fee schedule reference provides a structured overview of how procedure code fee schedules work across different payer contexts.

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