Summary & Overview
CPT 01380: Anesthesia for Knee Arthroscopy Procedures
CPT code 01380 represents anesthesia for arthroscopic procedures on the knee joint, a common intervention in orthopedic surgery. This code is nationally significant as it ensures precise billing and documentation for anesthesia services during minimally invasive knee operations, which are frequently performed in outpatient hospital settings. The publication covers major commercial payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, providing a comprehensive overview of payer coverage and policy considerations.
Readers will gain insights into the clinical context of knee arthroscopy, typical sites of service, and the role of anesthesia in these procedures. The summary also highlights relevant modifiers, associated provider taxonomies, and common ICD-10 diagnoses linked to knee pathology, offering a well-rounded perspective for stakeholders. Additionally, related CPT codes for knee procedures are discussed, supporting a broader understanding of coding practices and reimbursement trends. This resource is designed to inform healthcare professionals, billing specialists, and policy analysts about current benchmarks and updates in medical billing for anesthesia services in knee arthroscopy.
CPT Code Overview
CPT code 01380 is used to report anesthesia services for arthroscopic procedures performed on the knee joint. This code falls under the anesthesiology service type and is typically utilized in an outpatient hospital setting (Place of Service 22). The code is essential for accurately documenting and billing anesthesia care provided during minimally invasive knee surgeries, ensuring proper reimbursement and compliance with national standards.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to the outpatient hospital with knee pain, instability, or mechanical symptoms such as locking or catching. The patient may have a history of chronic instability, osteoarthritis, or a recent meniscal tear. After clinical evaluation and imaging, the orthopedic surgeon recommends an arthroscopic procedure on the knee joint to address the underlying pathology. An anesthesia provider, such as an anesthesiologist, certified registered nurse anesthetist (CRNA), or anesthesiology assistant, administers anesthesia for the arthroscopic procedure. The workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative recovery in the outpatient setting.
Coding Specifications
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Modifiers:
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QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care (MAC) during the procedure. -
QX: CRNA service with medical direction by a physician. Used when a CRNA provides anesthesia services under the medical direction of a physician.
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Provider Taxonomies:
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