Summary & Overview
CPT 00450: Anesthesia for Clavicle and Scapula Procedures
CPT code 00450 covers anesthesia for procedures performed on the clavicle and scapula, a critical area in orthopedic and trauma surgery. This code is widely used by anesthesiology professionals in outpatient hospital settings, reflecting its importance in both routine and complex shoulder surgeries. Nationally, the code is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing these procedures.
The publication provides a comprehensive overview of 00450, including payer coverage, clinical context, and relevant billing modifiers. Readers will gain insight into typical use cases, associated diagnoses, and related CPT codes, offering a clear understanding of how this code fits into the broader landscape of anesthesia billing. Policy updates and benchmarks are also discussed, equipping healthcare professionals and administrators with the information needed to navigate reimbursement and compliance for anesthesia services on the clavicle and scapula. The analysis highlights the significance of accurate coding and documentation, supporting efficient claims processing and quality patient care.
CPT Code Overview
CPT code 00450 is designated for anesthesia services provided during procedures involving the clavicle and scapula. This code falls under the anesthesiology service type and is most commonly utilized in the outpatient hospital setting, specifically at Place of Service 22. The code is essential for accurately capturing anesthesia care for a range of surgical interventions on the shoulder girdle, ensuring proper documentation and billing for these specialized procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to the outpatient hospital with acute pain and limited mobility in the right shoulder following a fall. Imaging reveals a fracture of the right clavicle (S42.001A) and possible rotator cuff tear (M75.100). The patient is scheduled for surgical repair of the clavicle, requiring anesthesia services for the procedure. An anesthesiologist or a certified registered nurse anesthetist (CRNA) provides anesthesia care, ensuring patient comfort and safety throughout the operation. The clinical workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative recovery in the outpatient setting.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure.QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia under the medical direction of an anesthesiologist.
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Provider Taxonomies:
Taxonomy Code Specialty Name