Summary & Overview

CPT 00702: Anesthesia for Upper Anterior Abdominal Wall Procedures

CPT code 00702 covers anesthesia for procedures on the upper anterior abdominal wall, such as percutaneous liver biopsy. This code is nationally recognized and plays a critical role in ensuring proper billing and reimbursement for anesthesia services in hospital settings. The publication examines coverage and policy details from major payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare.

Readers will gain insight into payer-specific coverage, common billing modifiers, and associated provider taxonomies relevant to 00702. The summary also highlights typical clinical scenarios, such as inpatient procedures requiring anesthesia, and provides context on related CPT codes for abdominal wall surgeries. Policy updates and benchmarks are discussed to inform stakeholders about current trends and requirements for anesthesia billing. The publication is designed to support healthcare professionals, administrators, and policy analysts in understanding the national landscape for anesthesia services tied to upper abdominal procedures.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareCPT 00702anesthesiologyabdominal wall proceduresinpatient hospitalmedical billinganesthesia codingpolicy updatesclinical benchmarksprocedure reimbursementupper anterior abdominal wall

CPT Code Overview

CPT code 00702 is used to report anesthesia services for procedures performed on the upper anterior abdominal wall, including percutaneous liver biopsy. This code falls under the anesthesiology service type and is typically provided in an inpatient hospital setting (Place of Service 21). The use of this code ensures accurate billing and documentation for anesthesia care during these specific surgical procedures.

Clinical & Coding Specifications

Clinical Context

A typical patient scenario involves an adult admitted to an inpatient hospital for evaluation and management of sepsis. The patient requires a percutaneous liver biopsy to assess hepatic involvement or complications related to their infection. An anesthesia provider, such as an anesthesiology physician, certified registered nurse anesthetist, or anesthesiology assistant, administers anesthesia for the procedure on the upper anterior abdominal wall. The clinical workflow includes pre-procedure assessment, anesthesia induction, monitoring during the biopsy, and post-procedure recovery.

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care during the procedure.
- QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist provides anesthesia under physician supervision.
Provider Taxonomies:

Taxonomy Code	Specialty Name
`207L00000X`	Anesthesiology Physician
`367500000X`	Certified Registered Nurse Anesthetist
`207RA0401X`	Anesthesiology Assistant

These taxonomies represent the specialties eligible to report anesthesia services for this procedure.

Related Diagnoses

A40.3: Sepsis due to Streptococcus pneumoniae. Relevant when liver biopsy is performed to evaluate complications from pneumococcal sepsis.
A40.9: Streptococcal sepsis, unspecified. Indicates sepsis of streptococcal origin, potentially requiring liver biopsy for diagnostic purposes.
A41.01: Sepsis due to Methicillin susceptible Staphylococcus aureus. Used when liver involvement is suspected in staphylococcal sepsis.
A41.02: Sepsis due to Methicillin resistant Staphylococcus aureus. Relevant for cases of MRSA sepsis with possible hepatic complications.
A41.1: Sepsis due to other specified staphylococcus. Indicates sepsis from other staphylococcal species, possibly necessitating liver biopsy.
A41.2: Sepsis due to unspecified staphylococcus. Used when the staphylococcal species is not identified.
A41.3: Sepsis due to Hemophilus influenzae. Relevant for sepsis caused by H. influenzae, with liver biopsy indicated for further evaluation.
A41.4: Sepsis due to anaerobes. Used when anaerobic organisms cause sepsis, and liver biopsy is needed to assess hepatic involvement.
A41.50: Gram-negative sepsis, unspecified. Indicates sepsis from gram-negative bacteria, with liver biopsy performed for diagnostic clarification.
A41.51: Sepsis due to Escherichia coli [E. coli]. Relevant for E. coli sepsis with possible liver complications.
A41.52: Sepsis due to Pseudomonas. Used when Pseudomonas sepsis may affect the liver.
A41.53: Sepsis due to Serratia. Indicates sepsis from Serratia species, with liver biopsy for evaluation.
A41.54: Sepsis due to Acinetobacter baumannii. Relevant for Acinetobacter sepsis with hepatic concerns.
A41.59: Other Gram-negative sepsis. Used for sepsis from other gram-negative organisms.
A41.89: Other specified sepsis. Indicates sepsis from other specified organisms, with liver biopsy as part of the workup.
A41.9: Sepsis, unspecified organism. Used when the causative organism is not identified, and liver biopsy is performed to aid diagnosis.

These diagnoses are clinically relevant as they represent infectious conditions that may necessitate percutaneous liver biopsy to evaluate hepatic involvement or complications, thus requiring anesthesia services as described by 00702.

Related CPT Codes

49505: Repair initial inguinal hernia, age 5 years or older; reducible. This code may be used when hernia repair is performed on the upper anterior abdominal wall, potentially requiring anesthesia services similar to 00702.
49585: Repair umbilical hernia, age 5 years or older; reducible. This procedure involves the abdominal wall and may be performed in conjunction with or as an alternative to procedures covered by 00702.
49650: Laparoscopy, surgical; repair initial inguinal hernia. This minimally invasive hernia repair may require anesthesia services comparable to those described by 00702.
49560: Repair initial incisional or ventral hernia; reducible. This code relates to abdominal wall procedures that may necessitate anesthesia as specified by 00702.

These codes are clinically related as they involve surgical interventions on the upper anterior abdominal wall, often requiring anesthesia services. They may be used together in complex cases or as alternatives depending on the specific surgical indication.

Summary & Overview

CPT 00702: Anesthesia for Upper Anterior Abdominal Wall Procedures

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifiers:
- QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care during the procedure.
- QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist provides anesthesia under physician supervision.
Provider Taxonomies:

Taxonomy Code	Specialty Name
`207L00000X`	Anesthesiology Physician
`367500000X`	Certified Registered Nurse Anesthetist
`207RA0401X`	Anesthesiology Assistant

These taxonomies represent the specialties eligible to report anesthesia services for this procedure.

Related Diagnoses

A40.3: Sepsis due to Streptococcus pneumoniae. Relevant when liver biopsy is performed to evaluate complications from pneumococcal sepsis.
A40.9: Streptococcal sepsis, unspecified. Indicates sepsis of streptococcal origin, potentially requiring liver biopsy for diagnostic purposes.
A41.01: Sepsis due to Methicillin susceptible Staphylococcus aureus. Used when liver involvement is suspected in staphylococcal sepsis.
A41.02: Sepsis due to Methicillin resistant Staphylococcus aureus. Relevant for cases of MRSA sepsis with possible hepatic complications.
A41.1: Sepsis due to other specified staphylococcus. Indicates sepsis from other staphylococcal species, possibly necessitating liver biopsy.
A41.2: Sepsis due to unspecified staphylococcus. Used when the staphylococcal species is not identified.
A41.3: Sepsis due to Hemophilus influenzae. Relevant for sepsis caused by H. influenzae, with liver biopsy indicated for further evaluation.
A41.4: Sepsis due to anaerobes. Used when anaerobic organisms cause sepsis, and liver biopsy is needed to assess hepatic involvement.
A41.50: Gram-negative sepsis, unspecified. Indicates sepsis from gram-negative bacteria, with liver biopsy performed for diagnostic clarification.
A41.51: Sepsis due to Escherichia coli [E. coli]. Relevant for E. coli sepsis with possible liver complications.
A41.52: Sepsis due to Pseudomonas. Used when Pseudomonas sepsis may affect the liver.
A41.53: Sepsis due to Serratia. Indicates sepsis from Serratia species, with liver biopsy for evaluation.
A41.54: Sepsis due to Acinetobacter baumannii. Relevant for Acinetobacter sepsis with hepatic concerns.
A41.59: Other Gram-negative sepsis. Used for sepsis from other gram-negative organisms.
A41.89: Other specified sepsis. Indicates sepsis from other specified organisms, with liver biopsy as part of the workup.
A41.9: Sepsis, unspecified organism. Used when the causative organism is not identified, and liver biopsy is performed to aid diagnosis.

Related CPT Codes

49505: Repair initial inguinal hernia, age 5 years or older; reducible. This code may be used when hernia repair is performed on the upper anterior abdominal wall, potentially requiring anesthesia services similar to 00702.
49585: Repair umbilical hernia, age 5 years or older; reducible. This procedure involves the abdominal wall and may be performed in conjunction with or as an alternative to procedures covered by 00702.
49650: Laparoscopy, surgical; repair initial inguinal hernia. This minimally invasive hernia repair may require anesthesia services comparable to those described by 00702.
49560: Repair initial incisional or ventral hernia; reducible. This code relates to abdominal wall procedures that may necessitate anesthesia as specified by 00702.

National Reimbursement Benchmarks

For CPT code 00702, national mean rates among commercial payers show significant variation. Cigna has the highest mean rate at $247.93, followed by Blue Cross Blue Shield at $228.46, and Aetna at $168.07. UnitedHealth Group is notably lower at $65.62, while BUCA (average commercial) stands at $126.92. Medicare rates are not available in the input for comparison.

Rate dispersion, measured by the difference between the 75th and 25th percentiles, is widest for Cigna ($259.00) and Aetna ($250.00), indicating greater variability in contracted rates. Blue Cross Blue Shield ($128.50) and BUCA ($137.33) have moderate dispersion, while UnitedHealth Group is the tightest at $25.47, reflecting more consistent rates across providers.

The table and chart below present the full breakdown of national benchmarks for each payer.

State Benchmarks

State: Alaska1 / 50

Alaska Benchmarks

Alaska displays a wide spread in reimbursement rates for CPT code 00702, with Blue Cross Blue Shield showing the largest range between the 25th and 75th percentiles ($74.20), while Aetna and UnitedHealth Group have minimal spread ($0.00 and $4.00, respectively). This indicates that some payers, like Blue Cross Blue Shield and BUCA, offer more variable rates, whereas others maintain consistent reimbursement levels across providers.

Compared to national averages, Alaska's mean rates for most payers are substantially higher, particularly for Blue Cross Blue Shield and BUCA. The table and chart below present the full breakdown of payer-specific rates, highlighting the differences in reimbursement across the major commercial payers in Alaska.

Key Insights for Alaska

Blue Cross Blue Shield is the highest paying payer for CPT 00702 in Alaska, with a mean rate of $269.26.
UnitedHealth Group offers the lowest mean rate at $75.12, significantly below both the state and national averages.
Alaska's mean rates for most payers are notably higher than national benchmarks, especially for Blue Cross Blue Shield and BUCA.

CPT 00732: Anesthesia for ERCP to Proximal Duodenum

00770-ANESTHESIA-FOR-PROCEDURES-ON-THE-MAJOR-ABDOMINAL-BLOOD

CPT 00770: Anesthesia for Major Abdominal Vascular Procedures

00750-ANESTHESIA-FOR-HERNIA-REPAIRS-IN-UPPER-ABDOMEN-NOT

CPT 00750: Anesthesia for Upper Abdominal Hernia Repair

00790-ANESTHESIA-FOR-INTRAPERITONEAL-PROCEDURES-IN-UPPER-ABDOMEN

CPT 00790: Anesthesia for Upper Abdominal Intraperitoneal Procedures

CPT-00731-UPPER-GI-ENDOSCOPY-ANESTHESIA

CPT 00731: Anesthesia for Upper Gastrointestinal Endoscopy, Proximal Duodenum

00792-ANESTHESIA-FOR-INTRAPERITONEAL-PROCEDURES-IN-UPPER-ABDOMEN

CPT 00792: Anesthesia for Partial Hepatectomy or Liver Hemorrhage Procedures

00730-ANESTHESIA-FOR-PROCEDURES-ON-UPPER-POSTERIOR-ABDOMINAL

CPT 00730: Anesthesia for Upper Posterior Abdominal Wall Procedures

00754-ANESTHESIA-FOR-PROCEDURES-ON-THE-SHOULDER-AND-AXILLA-NOT

CPT 00754: Anesthesia for Shoulder and Axilla Procedures

00756-UNDER-ANESTHESIA-FOR-PROCEDURES-ON-THE-UPPER

CPT 00756: Anesthesia for Procedures on the Upper Abdomen

00752-ANESTHESIA-FOR-HERNIA-REPAIRS-IN-UPPER-ABDOMEN-LUMBAR-AND

CPT 00752: Anesthesia for Upper Abdominal Hernia Repairs

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OpenPayer

Summary & Overview

CPT 00702: Anesthesia for Upper Anterior Abdominal Wall Procedures

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

OpenPayer

Summary & Overview

CPT 00702: Anesthesia for Upper Anterior Abdominal Wall Procedures

CPT Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes

National Reimbursement Benchmarks

State Benchmarks

Alaska Benchmarks

Key Insights for Alaska

Related Codes