Summary & Overview
CPT 01634: Anesthesia for Shoulder Disarticulation Procedures
CPT code 01634 represents anesthesia for complex shoulder procedures, including shoulder disarticulation, and is a critical billing code for anesthesiology services in surgical settings. This code is nationally relevant due to its application in major orthopedic and trauma surgeries, where precise anesthesia management is essential for patient safety and surgical outcomes. The publication covers key payers such as Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, providing a comprehensive overview of payer coverage and policy considerations for this anesthesia service.
Readers will gain insight into the clinical context of 01634, including its typical use in inpatient hospital environments and its role in supporting surgical teams during high-risk procedures. The summary also highlights common modifiers and associated taxonomies, offering clarity on billing practices and provider qualifications. Additionally, the publication addresses relevant ICD-10 diagnoses and related CPT codes, equipping stakeholders with the information needed to understand coding benchmarks and policy updates. This resource is designed for healthcare professionals, billing specialists, and policy analysts seeking authoritative information on anesthesia coding for shoulder disarticulation procedures.
CPT Code Overview
CPT code 01634 is used to report anesthesia services for open or surgical arthroscopic procedures involving the humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint, specifically for shoulder disarticulation. This code is classified under the anesthesia service type and is most commonly performed in an inpatient hospital setting (Place of Service 21). The procedure requires specialized anesthesia care due to the complexity and invasiveness of shoulder disarticulation surgeries.
Clinical & Coding Specifications
Clinical Context
A patient is admitted to an inpatient hospital for a complex shoulder procedure, such as a shoulder disarticulation, due to severe joint disease or trauma. The patient may have a history of osteoarthritis or previous joint replacement. An anesthesiology provider, such as a physician anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA), administers anesthesia for the open or surgical arthroscopic procedure involving the humeral head and neck, sternoclavicular joint, acromioclavicular joint, or shoulder joint. The clinical workflow includes preoperative assessment, anesthesia induction, intraoperative monitoring, and postoperative care in the hospital setting.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider is present and monitoring the patient, but not providing general anesthesia.QX: CRNA service with medical direction by a physician. Used when a CRNA is providing anesthesia under the supervision of a physician anesthesiologist.
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Provider Taxonomies:
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