Summary & Overview
CPT 01474: Anesthesia for Lower Leg, Ankle, and Foot Procedures
CPT code 01474 represents anesthesia services for surgical procedures on nerves, muscles, tendons, and fascia of the lower leg, ankle, and foot, specifically below the knee. This code is widely used in surgical settings, including hospital operating rooms and ambulatory surgery centers, to ensure proper billing and documentation of anesthesia care during lower extremity interventions. Nationally, the code is relevant for a range of orthopedic and podiatric procedures, making it a key component in perioperative management and reimbursement.
Major payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare. The publication provides an overview of payer coverage, common billing modifiers, and associated clinical taxonomies. Readers will gain insights into policy updates, clinical context, and benchmarks related to anesthesia services for lower extremity procedures. The summary also highlights relevant ICD-10 diagnoses and related CPT codes, offering a comprehensive view of how 01474 fits into broader surgical and anesthesia billing practices. This information is valuable for understanding national trends in anesthesia reimbursement and compliance for lower leg, ankle, and foot surgeries.
CPT Code Overview
CPT code 01474 is used to report anesthesia services for procedures involving nerves, muscles, tendons, and fascia of the lower leg, ankle, and foot (below the knee). This code applies to cases where anesthesia is required for surgical interventions in these anatomical regions. The service type is anesthesia, and the typical site of service includes a surgical setting such as a hospital operating room or an ambulatory surgery center. This code is essential for accurately documenting and billing anesthesia care provided during lower extremity procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult patient presenting with chronic knee pain due to unilateral primary osteoarthritis. The patient is scheduled for a surgical procedure on the nerves, muscles, tendons, or fascia of the lower leg, ankle, or foot (below the knee) in a hospital operating room or ambulatory surgery center. An anesthesiologist or certified registered nurse anesthetist (CRNA) provides anesthesia services to ensure patient comfort and safety during the procedure. The clinical workflow includes preoperative assessment, administration of anesthesia, intraoperative monitoring, and postoperative care.
Coding Specifications
Common Modifiers:
| Modifier Code | Description |
|---|---|
AA | Anesthesia services performed personally by anesthesiologist |
QK | Medical direction of two, three, or four concurrent anesthesia procedures |
QX | CRNA service with medical direction by a physician |
QZ | CRNA service without medical direction by a physician |
Associated Provider Taxonomies:
207L00000X- Anesthesiology: Physicians specializing in anesthesia care.207LA0401X- Pain Medicine (Anesthesiology): Physicians specializing in pain management within anesthesiology.367500000X- Certified Registered Nurse Anesthetist: Advanced practice nurses providing anesthesia services.
Related Diagnoses
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M17.10- Unilateral primary osteoarthritis, unspecified knee- Indicates osteoarthritis affecting one knee, relevant for patients undergoing procedures due to joint pain or dysfunction.
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M17.11- Unilateral primary osteoarthritis, right knee- Specifies osteoarthritis in the right knee, often leading to surgical intervention below the knee.
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M17.12- Unilateral primary osteoarthritis, left knee- Specifies osteoarthritis in the left knee, relevant for procedures addressing pain or mobility issues.
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M17.5- Other unilateral secondary osteoarthritis of knee- Refers to secondary osteoarthritis in one knee, which may necessitate surgical procedures on lower leg structures.
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Z96.651- Presence of right artificial knee joint- Indicates a patient with a right knee prosthesis, relevant for anesthesia during procedures on the lower leg, ankle, or foot.
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Z96.652- Presence of left artificial knee joint- Indicates a patient with a left knee prosthesis, relevant for anesthesia during procedures below the knee.
Related CPT Codes
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01472- Anesthesia for procedures on nerves, muscles, tendons, and fascia of lower leg, ankle, and foot (including repair of ruptured Achilles tendon, with or without graft)- This code is used for more specific procedures, such as Achilles tendon repair, and may be selected instead of
01474when the procedure involves the Achilles tendon.
- This code is used for more specific procedures, such as Achilles tendon repair, and may be selected instead of
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01480- Anesthesia for open procedures on bones of the lower leg, ankle, and foot- This code is used when the surgical procedure involves open operations on the bones, rather than soft tissue. It may be used as an alternative to
01474depending on the surgical approach and anatomical structures involved.
- This code is used when the surgical procedure involves open operations on the bones, rather than soft tissue. It may be used as an alternative to
These codes are related to 01474 and are selected based on the specific surgical procedure performed. They are not typically used together but may be alternatives depending on the operative site and technique.