Summary & Overview
CPT 01670: Anesthesia for Procedures on the Shoulder and Axilla
CPT code 01670 is designated for anesthesia services provided during procedures on the shoulder and axilla, a critical area for orthopedic and surgical interventions. This code is widely used across outpatient hospital settings, reflecting its importance in facilitating safe and effective care for patients undergoing shoulder and axilla procedures. Nationally, the code is recognized by major commercial payers including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, ensuring broad coverage and reimbursement for anesthesia professionals.
This publication provides a comprehensive overview of CPT code 01670, including payer coverage, clinical context, and relevant billing considerations. Readers will gain insight into the typical site of service, associated modifiers, and the professional taxonomies involved in delivering anesthesia care for these procedures. The summary also highlights related CPT codes and common ICD-10 diagnoses linked to shoulder and axilla interventions, offering a clear understanding of how this code fits within broader clinical and billing workflows. Policy updates and benchmarks are discussed to inform stakeholders about current trends and requirements for anesthesia billing in outpatient hospital settings. The information is designed to support healthcare professionals, administrators, and policy analysts in navigating the complexities of anesthesia coding and reimbursement.
CPT Code Overview
CPT code 01670 is used to report anesthesia services for procedures performed on the shoulder and axilla. This code applies to cases where anesthesia is required to facilitate surgical or diagnostic interventions in these anatomical regions. The service type is anesthesia, and the typical site of service is an outpatient hospital (Place of Service 22). This code is essential for accurately documenting and billing anesthesia care provided during shoulder and axilla procedures.
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves an adult presenting to the outpatient hospital with pain or injury localized to the shoulder or axilla. The patient may have a diagnosis such as sprain of the right ankle or pain in the foot, but the procedure is focused on the shoulder region. The clinical workflow includes preoperative assessment by the anesthesia provider, administration of anesthesia for a surgical or diagnostic procedure on the shoulder or axilla, intraoperative monitoring, and post-anesthesia care. Providers involved may include an anesthesiology physician, certified registered nurse anesthetist, or anesthesiology assistant.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when the anesthesia provider delivers monitored anesthesia care rather than general anesthesia.QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist provides anesthesia under the medical direction of a physician.
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Provider Taxonomies:
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