Summary & Overview
CPT 00860: Anesthesia for Extraperitoneal Lower Abdominal Procedures
CPT 00860 designates anesthesia services for extraperitoneal procedures in the lower abdomen, including operations involving the urinary tract. This code captures perioperative anesthetic management for a range of lower abdominal surgical procedures and is important for accurate billing, clinical documentation, and appropriate payment across surgical and anesthesia service lines. Nationally, proper use of the code supports clear communication between anesthesia providers, surgeons, and payers and helps ensure the procedural context for anesthetic services is recorded.
Major commercial payers relevant to this code include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. Readers will find an overview of the code’s clinical scope and typical hospital-based sites of service, guidance on common billing modifiers and provider taxonomies associated with anesthesia delivery, examples of common ICD-10 diagnoses paired with the procedure, and a brief comparison to a closely related CPT code (00862).
The publication provides a concise reference for coding and billing teams, anesthesia departments, and practice managers seeking clarity on when CPT 00860 is appropriate, how it relates to ancillary anesthesia services, and what diagnostic contexts commonly accompany its use. Data not available in the input.
CPT Code Overview
CPT 00860 describes anesthesia for extraperitoneal procedures in the lower abdomen, including the urinary tract. This service falls under Anesthesiology and typically applies when anesthesia care is provided for surgeries that access the lower abdominal extraperitoneal space.
The procedure is most commonly billed in hospital operating room settings, including Hospital – Outpatient (POS 22) and Inpatient (POS 21).
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Clinical & Coding Specifications
Clinical Context
A 56-year-old patient presents for surgical repair of a symptomatic right-sided inguinal hernia. The surgical team schedules an open extraperitoneal lower abdominal approach under general anesthesia with regional block as indicated. Preoperative evaluation is performed in the hospital preoperative area; consent is obtained and anesthesia assessment documents airway, comorbidities, and planned anesthetic technique. The patient is transported to the hospital operating room (commonly billed as Hospital – Inpatient POS 21 or Hospital – Outpatient POS 22). Intraoperative management includes induction, airway maintenance, hemodynamic monitoring, fluid management, and perioperative analgesia. The anesthesia service is documented in the anesthesia record and coded using 00860 for anesthesia for extraperitoneal procedures in the lower abdomen, including urinary tract. If a certified registered nurse anesthetist (CRNA) provides the service with physician medical direction, the QX modifier is appended; if monitored anesthesia care is provided instead of general anesthesia, the QS modifier may be applied. Post-anesthesia care occurs in the PACU with handoff to recovery nursing and the surgical team for postoperative orders and disposition.
Coding Specifications
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Modifiers:
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QS: Monitored anesthesia care service. Use when the anesthesia service provided is monitored anesthesia care rather than a general or regional anesthetic for the listed procedure.
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