Summary & Overview
CPT 00790: Anesthesia for Upper Abdominal Intraperitoneal Procedures
CPT code 00790 covers anesthesia for intraperitoneal procedures in the upper abdomen, including laparoscopy, when not otherwise specified. This code is significant for hospitals and surgical teams nationwide, as it applies to a broad spectrum of abdominal surgeries requiring specialized anesthesia care. The code is most frequently used in inpatient hospital settings, reflecting its role in major surgical interventions.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Understanding how these payers approach coverage and reimbursement for CPT 00790 is essential for providers, billing teams, and policy analysts seeking to navigate the complexities of anesthesiology billing.
Readers will gain insight into national benchmarks, payer policy updates, and the clinical context surrounding the use of CPT 00790. The publication also highlights relevant modifiers, associated provider taxonomies, and common clinical diagnoses linked to this code. By examining these elements, stakeholders can better understand the operational and policy landscape for anesthesia services in upper abdominal procedures.
CPT Code Overview
CPT 00790 is used to report anesthesia services for intraperitoneal procedures in the upper abdomen, including laparoscopy, when not otherwise specified. This code falls under the anesthesiology service type and is most commonly performed in an inpatient hospital setting (POS 21). It is utilized for a range of surgical interventions requiring anesthesia in the upper abdominal region, ensuring patient comfort and safety during complex procedures.
Clinical & Coding Specifications
Clinical Context
A patient is admitted to an inpatient hospital for a surgical procedure involving the upper abdomen, such as a laparoscopic cholecystectomy, appendectomy, or repair of an inguinal hernia. The patient may present with conditions like acute appendicitis, intestinal obstruction, or diverticulosis. An anesthesiology provider, such as an anesthesiologist, certified registered nurse anesthetist (CRNA), or anesthesiology assistant, administers anesthesia for the intraperitoneal procedure. The clinical workflow includes preoperative assessment, induction and maintenance of anesthesia during the surgery, and postoperative monitoring in the recovery area.
Coding Specifications
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Modifiers:
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QS: Monitored anesthesia care service. Used when the anesthesia provider is present and monitoring the patient, but not providing general anesthesia. -
QX: CRNA service with medical direction by a physician. Used when a CRNA is providing anesthesia care under the medical direction of a physician.
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Provider Taxonomies:
Taxonomy Code Specialty Name