CPT 00144: Anesthesia for Corneal Transplantation
CPT code 00144 denotes anesthesia services for patients undergoing corneal transplant surgery. Nationally, this code captures the anesthesia component of ophthalmic transplant procedures and is important for surgical care coordination, resource allocation, and procedural coding consistency across facilities performing corneal grafts. The code applies when an anesthesia provider administers and manages anesthesia care during corneal transplantation.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of clinical context for corneal transplant anesthesia, typical sites of service (operating rooms and ambulatory surgical centers), and how the code aligns with related ophthalmic surgical services. The publication also summarizes common clinical scenarios where the anesthesia code is used and highlights related procedural codes clinicians and billing staff commonly encounter.
This report is intended for national audiences involved in perioperative care, medical billing, and health plan policy. It provides benchmarking context, coding relationships to related ophthalmic procedures, and background useful for charge capture and claims submission workflows. Data not available in the input is noted where applicable.
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Billing Code Overview
CPT code 00144 describes anesthesia services provided for a patient undergoing a corneal transplant. This service represents perioperative anesthesia management specific to ophthalmic surgery involving transplantation of corneal tissue.
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Service type: Anesthesia service for corneal transplant surgery
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Typical site of service: Operating room or ambulatory surgical center where corneal transplant procedures are performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with advanced corneal decompensation from prior ocular surface disease and visually significant cataract is scheduled for penetrating keratoplasty (corneal transplant) under monitored anesthesia care or general endotracheal anesthesia. Preoperative evaluation by the anesthesia team documents medical history (controlled hypertension, well-controlled type 2 diabetes), airway assessment, medication reconciliation including anticoagulants, and informed consent for anesthesia risks. On the day of surgery the perioperative workflow includes preoperative timeout, placement of intravenous access, administration of perioperative antibiotics by the surgical team, application of standard monitoring (pulse oximetry, ECG, noninvasive blood pressure) and, if indicated, placement of a peripheral nerve block or retrobulbar block for supplemental ocular anesthesia. The anesthesiologist documents the start and end times of anesthesia care, hemodynamic management, airway technique (e.g., endotracheal tube or laryngeal mask airway), and emergence. Postoperative handoff to the recovery nurse includes documentation of airway status, pain control, antiemetic use, and instructions for ocular protective measures. The anesthesia service supports intraoperative globe stability and hemodynamic optimization during microsurgical corneal graft placement and potential concurrent procedures (for example cataract extraction or intraocular lens implantation).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AA | Anesthesia services performed personally by an anesthesiologist | Use when an MD/DO anesthesiologist personally performs the anesthesia service for 00144. |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | Use when the anesthesiologist supervises multiple anesthesia providers beyond four concurrent cases. |
QK | Medical direction of two, three, or four qualified individuals or nurse anesthetists | Use when the anesthesiologist medically directs multiple CRNAs for 00144 and meets CMS direction criteria. |
QX | CRNA service furnished under the supervision of a physician | Use when a Certified Registered Nurse Anesthetist furnishes the service under physician supervision. |
QS | Monitored anesthesia care service | Use when the service is billed as monitored anesthesia care rather than general anesthesia for ocular surgery. |
23 | Unusual anesthesia — for emergency surgery | Use when 00144 is provided for an emergency corneal transplant requiring unusual circumstances. |
22 | Increased procedural services | Use when complexity of anesthesia care for 00144 is substantially greater than usual and requires additional work. |
62 | Two surgeons | Use if two surgeons are required intraoperatively (e.g., corneal surgeon plus complex anterior segment surgeon) affecting anesthesia coordination. |
78 | Unplanned return to the operating room following initial procedure | Use when the patient returns to the OR for revision or graft-related complication requiring repeat anesthesia. |
50 | Bilateral procedure | Use if simultaneous bilateral corneal procedures are performed (rare) and anesthesia billing requires bilateral modifier. |
52 | Reduced services | Use when the full anesthesia service is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when anesthesia care is discontinued due to patient instability or procedure cancellation after induction. |
CR | Catastrophe/disaster related | Use in declared catastrophe situations where standard billing adjustments apply. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for Medicare | Use when the service involves advanced practitioner roles recognized by payors for anesthesia-related services. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists who provide direct anesthesia care for corneal transplant procedures. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who provide and document anesthesia services for ophthalmic surgeries including corneal transplants. |
207LA0401X | Anesthesiology Assistant | Anesthesiology assistants who work under physician supervision and participate in perioperative anesthesia management. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
H25.9 | Unspecified age-related cataract | Coexisting cataract is common in patients undergoing corneal transplant; may prompt combined procedures affecting anesthesia planning. |
H26.9 | Unspecified cataract | Non–age-related cataract that may coexist with corneal disease and influence intraoperative management and anesthesia duration. |
H27.9 | Unspecified disorder of lens | Lens pathology that can coexist with corneal disease and affect surgical approach and perioperative anesthesia care. |
H28 | Cataract in diseases classified elsewhere | Secondary cataract related to systemic or ocular disease; presence may require combined intraocular surgery with corneal transplant. |
H52.4 | Presbyopia | Refractive condition often present but not typically surgical indication for corneal transplant; relevant for preoperative visual assessment and counseling. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
66984 | Extracapsular cataract removal with insertion of intraocular lens prosthesis | May be performed concurrently or staged with corneal transplant when lens opacity contributes to visual impairment; anesthesia planning is coordinated if combined. |
66982 | Complex cataract surgery with insertion of intraocular lens prosthesis | Applies when cataract removal during corneal transplant requires complex techniques (e.g., iris prosthesis, zonular support) increasing anesthesia complexity. |
66821 | Discission of secondary membranous cataract | May be performed as a separate or adjunct anterior segment procedure; anesthesia documentation reflects additional intraocular interventions. |
67028 | Intravitreal injection of a pharmacologic agent | Performed preoperatively or postoperatively for management of concurrent retinal conditions; anesthesia team documents sedation or topical requirements if provided. |