Summary & Overview
CPT 01430: Anesthesia for Knee Joint Procedures, Not Otherwise Specified
CPT code 01430 represents anesthesia for procedures on the knee joint that are not otherwise specified, serving as a foundational billing code for anesthesiology services in orthopedic and surgical settings. This code is widely used across outpatient hospital environments, supporting a variety of knee interventions where specific anesthesia codes do not apply. Nationally, CPT 01430 is recognized by major payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage for patients undergoing knee procedures.
This publication provides a comprehensive overview of CPT 01430, including payer coverage, clinical context, and related coding benchmarks. Readers will gain insight into the typical use cases for this code, its relevance in anesthesiology practice, and how it fits within the broader landscape of knee procedure billing. The summary also highlights common modifiers and associated provider taxonomies, offering clarity on who may bill for these services. Policy updates and clinical benchmarks are discussed to inform stakeholders about current trends and requirements in anesthesia billing for knee procedures. This resource is designed to support healthcare professionals, administrators, and policy analysts seeking up-to-date information on anesthesia coding for knee interventions.
CPT Code Overview
CPT 01430 is designated for anesthesia services provided during procedures on the knee joint that are not otherwise specified. This code is utilized by professionals in the field of anesthesiology and is most commonly billed in the outpatient hospital setting, specifically at Place of Service 22. The code covers a range of knee procedures where anesthesia is required but does not fall under more specific anesthesia codes for knee surgeries. It is a key billing code for anesthesiology providers supporting orthopedic and surgical interventions on the knee.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with significant knee pain and limited mobility, often due to conditions such as unilateral primary osteoarthritis or a recent ligament sprain. The orthopedic surgeon schedules a procedure on the knee joint that does not fall under more specific surgical categories. An anesthesiology provider, such as an anesthesiology physician, certified registered nurse anesthetist, or anesthesiology assistant, administers anesthesia for the procedure. The clinical workflow includes preoperative assessment, anesthesia induction, intraoperative monitoring, and postoperative recovery, ensuring patient comfort and safety throughout the intervention.
Coding Specifications
Common Modifiers:
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QS- Monitored anesthesia care service: Used when the anesthesia provider delivers monitored anesthesia care, typically for procedures where deep sedation or general anesthesia is not required. -
QX- CRNA service with medical direction by a physician: Applied when a certified registered nurse anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.
Associated Provider Taxonomies:
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