Summary & Overview
CPT 00546: Anesthesia for Open Lung Resection and Thoracic Repair
CPT code 00546 describes anesthesia services for open thoracic surgery involving removal of all or part of a lung with surgical repair of the thorax. This code denotes high-acuity perioperative anesthetic management for procedures that carry significant physiologic risk, complex airway requirements, and potential for major intraoperative hemodynamic and respiratory challenges. Nationally, proper coding for these services affects hospital and anesthesia group billing, resource allocation in tertiary surgical centers, and alignment with surgical case complexity reporting.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for the code, how it maps to anesthesia service expectations, and comparisons to closely related anesthesia codes for other thoracic and cardiac procedures. The publication outlines common clinical scenarios associated with 00546, typical sites of service, and the role of this code within anesthesia service lines.
This summary equips billing managers, anesthesiology department leaders, and health policy analysts with a clear understanding of the code's clinical meaning, its place in service lines for major thoracic surgery, and what to expect when reconciling anesthesia claims for open lung resection and thoracic repair procedures.
Billing Code Overview
CPT code 00546 represents anesthesia services provided for a surgical procedure that involves opening the chest wall, removal of all or part of a lung, and surgical repair of the thorax. This service is provided by an anesthesia professional responsible for perioperative management, airway control, and physiologic support during a major thoracic operation.
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Service type: General anesthesia for major thoracic surgery involving lung resection and thoracic repair
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Typical site of service: Inpatient operating room or major procedural suite where open thoracic surgery is performed
Clinical & Coding Specifications
Clinical Context
A 6-month-old infant with hypoplastic left heart syndrome Q23.4 and associated ventricular septal defect Q21.0 is scheduled for a left pneumonectomy due to progressive pulmonary hypoplasia and recurrent infections. The surgical plan is a thoracotomy with removal of the affected lung and surgical repair of the thorax. The perioperative team includes pediatric cardiology, pediatric cardiac surgery, pediatric anesthesiology, and pediatric critical care medicine. Preoperative workflow includes multidisciplinary review of cardiac anatomy and physiology, optimization of volume status and inotropic support, airway assessment, and baseline labs and imaging. Intraoperative management focuses on general endotracheal anesthesia, invasive monitoring (arterial line and central venous access), possible single-lung ventilation strategies, hemodynamic optimization for congenital cardiac lesions, blood product availability, and coordination of potential extracorporeal support. Postoperative care includes transfer to the pediatric intensive care unit for ventilatory support, pain control, hemodynamic monitoring, and staged management of residual cardiac lesions such as coarctation of the aorta Q25.1 or total anomalous pulmonary venous connection Q26.2 if present.
Coding Specifications
| Modifier | Description | When to Use |
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