CPT 00472: Anesthesia for Partial Rib Resection with Thoracoplasty
CPT code 00472 denotes anesthesia services for partial rib resection with thoracoplasty, a specialized thoracic surgical procedure in which one or more ribs are partially removed and the chest wall may be repaired. This code captures the anesthetic component of complex chest wall surgery and is relevant for hospital, ambulatory surgery center, and inpatient surgical billing. Nationally, accurate use of this CPT code matters for appropriate claims processing, resource allocation for anesthesia services, and consistent clinical documentation for thoracic procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an overview of the clinical context for anesthesia during partial rib resection, common billing considerations, and links to related anesthesia codes for thoracic procedures. The publication highlights typical sites of service, the service type captured by the code, and how 00472 relates to other thoracic anesthesia codes. Benchmarks, policy updates, and payer-specific adjudication notes are summarized to help coding professionals and billing analysts align documentation and claim submission practices with national expectations.
Sign up for cpt 00472 policy alerts
Get alerted when payer policies referencing 00472 are released or updated.
Billing Code Overview
CPT code 00472 describes anesthesia services provided for a patient undergoing partial rib resection including thoracoplasty, in which another provider partially removes one or more ribs. The procedure may include reparative work on the thorax as part of the surgical intervention.
Service type: Intraoperative anesthesia for thoracic surgery involving partial rib resection / thoracoplasty.
Typical site of service: Operating room or other inpatient/outpatient surgical suite equipped for thoracic procedures and general anesthesia.
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with chronic pain and a localized chest wall deformity due to prior trauma is scheduled for a partial rib resection including thoracoplasty to remove diseased bone and reshape the thorax. Preoperative evaluation by the anesthesiology team documents comorbid hypertension and a history of tobacco use. The patient arrives on the day of surgery to an ambulatory surgical center affiliated with a hospital; the procedure is performed in an operating room under general endotracheal anesthesia with single-lung ventilation and intraoperative arterial monitoring. The anesthesiologist documents induction, maintenance, regional analgesia (eg, thoracic epidural or paravertebral block) for postoperative pain control, intraoperative hemodynamic management, and emergence. Postanesthesia care occurs in the PACU with handoff to the surgical team and discharge to inpatient surgical ward for monitoring when indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia complexity or intensity is substantially greater than usual for partial rib resection and supported by documentation of unusual circumstances. |
23 | Unusual anesthesia | Use when general anesthesia is medically contraindicated and an unusual anesthesia method is required (e.g., awake procedure with supplemental sedation), where payer recognizes 23. |
50 | Bilateral procedure | Use when identical procedures are performed on both sides of the thorax and payor requires bilateral reporting for anesthesia. |
52 | Reduced services | Use when the procedure is partially reduced or abbreviated but still performed (eg, limited rib resection). |
53 | Discontinued procedure | Use when procedure is started but terminated for patient safety prior to completion and anesthesia services correspond to that discontinued operation. |
54 | Surgical care only | Use when the anesthesiologist provides only intraoperative care and not pre- or post-operative anesthesia management due to transfer of care. |
55 | Postoperative management only | Use when the anesthesiologist provides only postoperative anesthesia pain management without intraoperative involvement. |
62 | Two surgeons | Use when co-surgeons are required for the rib resection and documentation supports concurrent surgical involvement affecting anesthesia management. |
78 | Unplanned return to the operating/procedure room | Use for anesthesia services rendered for a return to OR for complications related to the original rib resection. |
AA | Anesthesia by anesthesiologist | Use to identify services personally performed by a physician anesthesiologist. |
AD | Medical supervision by anesthesiologist | Use when the anesthesiologist supervises multiple anesthesia providers during the case. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Use when CRNA or anesthetist services are performed under appropriate supervision and payor requires AS reporting. |
QK | Medical direction of two, three, or four qualified individuals | Use when the anesthesiologist medically directs multiple qualified anesthesia personnel during the rib resection. |
QS | Monitored anesthesia care service | Use when MAC is provided instead of general anesthesia for portions or the entirety of the procedure and is allowed by payor policy. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists who perform perioperative anesthesia and invasive monitoring for thoracic procedures. |
207LA0401X | Anesthesiology Assistant | Anesthesiology assistants providing supervised anesthesia services in operative settings. |
207LC0200X | Critical Care Medicine (Anesthesiology) | Anesthesiologists with critical care training who may manage complex perioperative cardiopulmonary issues for major thoracic resections. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
H25.9 | Unspecified age-related cataract | Not typically related to chest wall surgery; may affect preoperative assessment for general anesthesia (visual impairment considerations for postoperative mobility and consent processes). |
H26.9 | Unspecified cataract | See H25.9 — relevant to perioperative counseling and postoperative care needs if visual impairment exists. |
H52.4 | Presbyopia | Visual impairment that may influence pre- and postoperative instructions comprehension and discharge planning. |
H53.8 | Other visual disturbances | May impact patient safety and discharge instructions following anesthesia and thoracic surgery. |
H54.8 | Legal blindness, as defined in USA | Significant visual disability affecting perioperative logistics, informed consent processes, and postoperative assistance; relevant to documentation of additional perioperative support needs. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
00474 | Under anesthesia for procedures on the thorax (chest wall and shoulder girdle) — anesthesia for partial rib resection (radical) | Alternative anesthesia code for more extensive or radical partial rib resections; used when the operation meets criteria for a more extensive service. |
00470 | Under anesthesia for procedures on the thorax (chest wall and shoulder girdle) — anesthesia for partial rib removal, unspecified procedure | Related code used when documentation does not specify the level of complexity; may be used for less well-defined rib removal procedures. |