Summary & Overview
CPT 00174: Anesthesia for Eye Lens Surgery
CPT 00174 denotes anesthesia services for eye procedures involving lens surgery, commonly used for cataract extraction and related intraocular lens procedures. Nationally, this code matters because anesthesia choice and documentation affect perioperative safety, coding accuracy, and appropriate billing for ophthalmic surgeries that are frequently performed in outpatient hospital settings. The code is primarily relevant to anesthesiology teams supporting ophthalmic surgeons.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find an overview of clinical context for lens surgery anesthesia, common coding scenarios and modifiers, relevant ICD-10 diagnoses tied to lens procedures, and related CPT procedures that typically interact with CPT 00174. The publication summarizes payer considerations, typical sites of service, and associated professional taxonomies for clinicians and billing professionals.
The article provides benchmarks for common billing configurations, a concise review of allowable settings and service descriptors, and cross-references to related ophthalmic procedure codes. Data not available in the input is noted where applicable. The focus is on clarifying the code’s scope, typical use cases, and the payer landscape to support accurate documentation and administrative processing in anesthesiology service lines.
CPT Code Overview
CPT 00174 describes anesthesia services provided for eye procedures involving lens surgery. This code is used for anesthetic care associated with cataract and other lens-related surgical procedures. The service type for CPT 00174 is Anesthesiology. The typical site of service for procedures billed with this code is Outpatient Hospital (POS 22).
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with progressive vision loss from a mature age-related cataract presents to an outpatient hospital surgical suite (POS 22) for elective lens extraction. Preoperative assessment by the anesthesia team documents airway, medical comorbidities, and plan for monitored anesthesia care or regional anesthesia based on patient status and surgeon preference. On the day of surgery, perioperative vital signs and sedation are administered by an anesthesiologist or certified registered nurse anesthetist while the ophthalmic surgeon performs phacoemulsification and intraocular lens placement. Postoperative recovery occurs in the outpatient PACU with monitoring for hemodynamic stability and ocular complications prior to discharge.
Coding Specifications
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Modifiers:
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QS- Monitored anesthesia care service. Use when anesthesia provided is documented as monitored anesthesia care for the ophthalmic procedure. -
QX- CRNA service with medical direction by a physician. Use when a Certified Registered Nurse Anesthetist delivers anesthesia services under physician medical direction and documentation supports the physician’s involvement. -
Provider taxonomies:
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