Summary & Overview
CPT 00754: Anesthesia for Shoulder and Axilla Procedures
CPT code 00754 represents anesthesia for procedures on the shoulder and axilla that are not otherwise specified, serving as a critical billing code for anesthesiology services in surgical settings. This code is widely used across outpatient hospitals, 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.
Readers will gain insight into the clinical context of 00754, including its application in shoulder and axilla surgeries, typical sites of service, and associated billing practices. The publication also highlights relevant modifiers, taxonomies, and related CPT codes, providing a comprehensive overview for healthcare professionals, billing specialists, and policy analysts. Key benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements in anesthesiology billing. Understanding the scope and utilization of 00754 is essential for accurate reimbursement and compliance in surgical anesthesia services.
CPT Code Overview
CPT code 00754 is used to report anesthesia services for procedures performed on the shoulder and axilla that are not otherwise specified. This code falls under the anesthesiology service type and is most commonly utilized in the outpatient hospital setting (Place of Service 22). It is designed to capture the complexity and requirements of providing anesthesia for a range of surgical interventions involving the shoulder and axillary region, ensuring appropriate billing and documentation for these specialized services.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with shoulder pain and limited mobility, potentially due to a rotator cuff tear, osteoarthritis, or a clavicle fracture. The orthopedic surgeon schedules a surgical procedure on the shoulder or axilla, such as arthroscopy or open repair. An anesthesiologist provides anesthesia services for the procedure, ensuring patient comfort and safety throughout. The anesthesia is tailored to the specific surgery and patient health status, and may involve monitored anesthesia care or general anesthesia. Documentation includes the anesthesia start and end times, patient status, and any modifiers relevant to the service.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care rather than general anesthesia.P1: A normal healthy patient. Indicates the patient's physical status as normal and healthy.
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
| 207L00000X |