CPT 00142: Anesthesia for Eye Lens Procedure
CPT code 00142 represents anesthesia services provided for patients undergoing eye lens procedures, most commonly cataract surgery with intraocular lens insertion. Anesthesia coding for ophthalmic lens procedures is nationally relevant because cataract surgery is one of the most frequent surgical procedures in older adults, and correct anesthesia reporting affects clinical documentation, care coordination, and payment processing. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise overview of what CPT code 00142 covers clinically, how it relates to common ophthalmic procedures, and which payers are included in coverage comparisons. The publication summarizes typical sites of service (ambulatory surgical centers and hospital operating rooms), common clinical scenarios that prompt use of the code, and related ophthalmology procedure codes commonly billed alongside anesthesia for lens surgeries. It also outlines benchmark and policy topics relevant to national payers and Medicare, and highlights documentation and coding contexts that affect claims adjudication. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 00142 describes anesthesia services provided for a patient undergoing an eye lens procedure. The service covers administration and management of anesthesia during procedures involving the eye's lens, such as cataract extraction with intraocular lens implantation.
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Service type: Anesthesia for ophthalmic lens procedures
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Typical site of service: Ambulatory surgical center or hospital operating room
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with progressive blurring of vision in the right eye presents to ophthalmology with decreased visual acuity and glare. Clinical exam documents an age-related cataract and preoperative assessment identifies controlled hypertension and well-managed type 2 diabetes. The patient is scheduled for elective extracapsular cataract extraction with intraocular lens placement. An anesthesia professional (anesthesiologist or certified registered nurse anesthetist) provides monitored anesthesia care or general anesthesia depending on patient comorbidities, cooperation, and surgical complexity. Preoperative evaluation includes airway assessment, review of medications (anticoagulants, antihypertensives), informed consent for anesthesia risks, and plan for sedation or regional ocular block. Intraoperative management includes sedation level titration, hemodynamic monitoring, supplemental oxygen, ocular block or topical anesthesia administration as indicated, and readiness to convert to general anesthesia if complications occur. Postoperative care involves emergence monitoring, pain and nausea management, and assessment of visual status before discharge with postoperative ophthalmic instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally performs and documents the anesthesia for the eye lens procedure. |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | Use when the physician supervises multiple anesthesia providers during concurrent cataract cases. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals | Use when an anesthesiologist medically directs CRNAs for concurrent cataract anesthesia cases. |
QX | CRNA service with medical direction by a physician | Use when a CRNA performs the anesthesia under physician direction for the eye procedure. |
QY | Medical direction of one certified registered nurse anesthetist by an anesthesiologist | Use when the anesthesiologist directs one CRNA for this procedure. |
QZ | CRNA service without medical direction by a physician | Use when a CRNA provides independent anesthesia services for the cataract case. |
47 | Anesthesia by surgeon | Use when the surgeon provides monitored anesthesia care or local anesthesia without an anesthesia professional. |
23 | Unusual anesthesia | Use when the procedure requires unusual anesthesia circumstances such as unexpected conversion to general anesthesia for the eye lens procedure. |
50 | Bilateral procedure | Use when cataract surgery and anesthesia are performed bilaterally during the same operative session. |
62 | Two surgeons | Use when two surgeons are documented as necessary for the ocular procedure requiring anesthesia. |
52 | Reduced services | Use when the anesthesia service is reduced or abbreviated and documentation supports partial performance. |
53 | Discontinued procedure | Use when anesthesia is provided but the procedure is terminated for reasons beyond control and documentation supports discontinuation. |
78 | Unplanned return to the operating room following anesthesia | Use when the patient requires an unplanned return to the OR for complication management under anesthesia. |
99 | Data not available in the input. | Data not available in the input. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician specialty performing anesthesia evaluation and delivery for ophthalmic procedures. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs commonly provide monitored anesthesia care or regional blocks for cataract surgery. |
207LA0401X | Anesthesiology Assistant | Anesthesia assistants may support anesthesiologists in perioperative care for eye procedures. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
H25.9 | Unspecified age-related cataract | Primary indication for cataract extraction and intraocular lens implantation requiring anesthesia services. |
H26.9 | Unspecified cataract | General cataract diagnosis that may necessitate surgical extraction and perioperative anesthesia. |
H52.4 | Presbyopia | Coexisting refractive condition often present in patients undergoing cataract evaluation; may influence IOL selection but is not the primary surgical diagnosis. |
H53.8 | Other visual disturbances | Symptom descriptor that can be associated with cataract-related visual impairment prompting surgery. |
H54.7 | Unspecified visual loss | Represents decreased vision severity that supports the medical necessity of cataract surgery with anesthesia. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | Primary surgical procedure for which anesthesia services coded by 00142 are commonly provided. |
66982 | Complex cataract surgery with insertion of intraocular lens prosthesis | Complex cataract cases that may require more extensive anesthesia management, potentially affecting anesthesia coding and time. |
92015 | Determination of refractive state | Preoperative assessment that may be performed by ophthalmology prior to definitive cataract surgery and anesthesia planning. |
92136 | Ophthalmic biometry by partial coherence interferometry with intraocular lens power calculation | Preoperative testing used to plan intraocular lens power; performed prior to the anesthetized surgical procedure. |