Summary & Overview
CPT 00836: Anesthesia for Lower Abdominal Hernia Repair in Preterm Infants
CPT 00836 designates anesthesia services for lower abdominal hernia repairs in infants who were born preterm (less than 37 weeks gestation) and remain younger than 50 weeks gestational age at the time of surgery. This code fills a specific clinical and billing niche by identifying anesthesia for procedures not otherwise classified under other pediatric or infant anesthesia codes. Nationally, precise coding for high-risk neonates and young infants is important for ensuring appropriate clinical documentation, payer adjudication, and care coordination in perioperative settings.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find a concise explanation of the code’s clinical scope, typical site of service, relevant diagnosis pairings, comparable anesthesia codes for related procedures, and common modifier usage for anesthesia physical status. The publication also summarizes how the code aligns with anesthesiology and pediatric anesthesiology practice contexts. Intended takeaways include clarity on the code’s appropriate clinical application, common ICD-10 diagnoses associated with these procedures, and how this code relates to nearby anesthesia codes used for pediatric and intraperitoneal procedures. Data not available in the input.
CPT Code Overview
CPT 00836 covers anesthesia for hernia repairs in the lower abdomen when the patient is an infant born at fewer than 37 weeks gestational age and younger than 50 weeks gestational age at the time of surgery. This code applies to anesthesia care for lower abdominal hernia repair procedures that are not specified by any other anesthesia code.
Service type: Anesthesia
Typical site of service: Outpatient Hospital (POS 22)
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A full-term clinical scenario describes an infant born at fewer than 37 weeks gestational age and younger than 50 weeks gestational age presenting for elective repair of a lower abdominal hernia (for example, inguinal or umbilical hernia). The perioperative workflow includes preoperative assessment by pediatric anesthesia, review of neonatal history and current physiologic status, optimization of respiratory and thermoregulatory needs, intraoperative general anesthesia with age-appropriate monitoring and medication dosing, and postoperative recovery in a pediatric PACU or neonatal observation area. The anesthesia team documents physical status using ASA modifiers and records the procedure-specific anesthesia code 00836 for billing and clinical records.
Coding Specifications
-
Modifiers
-
P1–P6: Physical status modifiers (ASA patient classification) are applicable to anesthesia services, including this code for infants. Use the patientspecific ASA physical status code that reflects the infant's overall preoperative health (for example,P1for a healthy infant, up toP6for a declared brain-dead patient whose organs are being removed for donor purposes). -
Provider taxonomies
| Taxonomy Code |
|---|