CPT 00140: Anesthesia for Eye Procedure, Ophthalmic Surgery
CPT code 00140 represents anesthesia services furnished for patients undergoing eye procedures. This code denotes perioperative anesthetic management specific to ophthalmic surgery and is used by anesthesia providers when billing for care tied to intraoperative anesthesia for the eye. Nationally, accurate use of this code affects anesthesia service reporting, payment allocation for operating-room based ophthalmic procedures, and clinical documentation for perioperative risk management.
Key payers considered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise account of how CPT code 00140 is defined, common clinical contexts in which it applies (for example cataract, glaucoma, corneal, and retinal procedures), and related CPT anesthesia codes for other ophthalmic procedures. The publication also summarizes payer coverage patterns, typical sites of service, and coding considerations that influence billing and claims processing.
This summary offers benchmarks and policy-relevant context to help administrators and coding professionals understand where CPT code 00140 fits within ophthalmic anesthesia services, how it aligns with related anesthesia codes for eye surgery, and what clinical scenarios commonly invoke its use.
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Billing Code Overview
CPT code 00140 describes anesthesia services provided for a patient undergoing an eye procedure. The service type is anesthesia for ophthalmic surgery, and the typical site of service is an operating room or ambulatory surgical center where eye procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with progressive vision loss from age-related cataract (H25.9) is scheduled for cataract extraction with intraocular lens implantation under monitored anesthesia care. Preoperative evaluation in the ambulatory surgery center includes airway assessment, review of comorbid glaucoma (H40.9) and intermittent visual disturbance (H53.9), medication reconciliation (anticoagulants, glaucoma drops), and consent for anesthesia. On the day of surgery the anesthesiology team provides regional block (peribulbar or retrobulbar) with sedation, or general anesthesia if the patient has severe anxiety, inability to cooperate, or medical contraindications to regional techniques. Intraoperative documentation includes start and stop times for anesthesia, agents and doses administered, airway management (e.g., mask, LMA, endotracheal tube), physiologic monitoring, and any anesthetic complications (e.g., severe hemodynamic instability). Postoperative care occurs in the PACU with monitoring for ocular pain, nausea, airway events, and return to baseline mental status before discharge or admission for higher-level care if complications occur. Typical payors for billing interactions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA, and Medicare.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual Anesthesia | Use when a procedure that normally requires minimal or no anesthesia becomes more complex and general anesthesia or substantially greater anesthesia is required for non-routine circumstances. |
50 | Bilateral Procedure | Use when identical bilateral ophthalmic procedures require anesthesia on both eyes during the same operative session. |
52 | Reduced Services | Use when the anesthesia service is partially reduced or not completed as planned. |
53 | Discontinued Procedure | Use when the procedure is started but terminated due to patient condition or intraoperative findings and anesthesia was provided. |
55 | Postoperative Management Only | Use when the anesthesiologist provides only postoperative pain management or follow-up, not intraoperative anesthesia. |
56 | Preoperative Management Only | Use when the anesthesiologist provides only preoperative evaluation and preparation without providing intraoperative care. |
62 | Two Surgeons | Use when two surgeons work together as primary surgeons on the same ophthalmic procedure and anesthesia documentation supports both. |
74 | Return to Operating Room for a Related Procedure by Same Physician | Use when the patient returns to the operating room for a related ophthalmic procedure during the global period and additional anesthesia is required. |
78 | Unplanned Return to Operating Room by Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period | Use for anesthesia services when an unplanned re-operation occurs for a complication of the original procedure. |
AA | Anesthesia by Anesthesiologist | Use when an M.D. or D.O. anesthesiologist personally performs the anesthesia service. |
AD | Medical Supervision by a Physician; More than Four Concurrent Anesthesia Procedures | Use when the physician supervises multiple concurrent anesthesia cases as defined by payer policy. |
QK | Medical Direction of Two, Three, or Four Certified Registered Nurse Anesthetists (CRNAs) | Use when an anesthesiologist medically directs multiple CRNAs as allowed by payer rules. |
QS | Monitored Anesthesia Care Service | Use to indicate monitored anesthesia care (MAC) was provided rather than general anesthesia. |
FY | Indicates Service Furnished as Part of a Clinic or Institution-Other Government Facility | Use when anesthesia services are billed from a federal facility environment requiring this modifier. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Board-certified physician anesthesiologists who provide primary anesthesia services for ophthalmic procedures. |
207LA0401X | Anesthesiology Assistant | Anesthesia assistants who work under physician supervision and may participate in delivery of anesthetic care according to state law. |
207LC0200X | Critical Care Medicine (Anesthesiology) | Anesthesiologists with critical care training who may manage complex ophthalmic patients with significant comorbidities. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
H57.9 | Unspecified disorder of eye and adnexa | Broad symptom/diagnosis that may prompt diagnostic or therapeutic ophthalmic procedures requiring anesthesia. |
H53.9 | Unspecified visual disturbance | Symptom-driven code indicating visual changes that can lead to surgical intervention under anesthesia. |
H40.9 | Unspecified glaucoma | Glaucoma may complicate intraocular procedures and influence anesthetic planning and perioperative pressure management. |
H25.9 | Unspecified age-related cataract | Primary indication for many lens surgeries; common reason to bill ophthalmic anesthesia codes. |
H10.9 | Unspecified conjunctivitis | Less commonly an indication for operative anesthesia but may co-exist; generally not a primary surgical indication. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
00142 | Anesthesia for procedures on eye; lens surgery | Directly related for anesthesia specific to cataract or lens procedures; may be used when the index anesthesia code does not match the specific lens surgery complexity. |
00144 | Anesthesia for procedures on eye; corneal transplant | Used when anesthesia is provided for corneal transplant procedures; relevant if the patient undergoes keratoplasty instead of or in addition to lens surgery. |
00145 | Anesthesia for procedures on eye; retinal detachment | Relevant when anesthesia is required for retinal detachment repair; differentiates posterior segment procedures from anterior segment. |
00147 | Anesthesia for procedures on eye; vitrectomy | Used for anesthesia for vitrectomy and other posterior segment surgeries; applicable when combined anterior and posterior procedures occur. |