Summary & Overview
CPT 00561: Infant Cardiac Anesthesia with Cardiopulmonary Bypass
CPT code 00561 designates anesthesia services for infants under one year undergoing major cardiac surgery involving the heart, pericardium and great vessels with use of a pump oxygenator (cardiopulmonary bypass). This code captures a high-acuity, resource-intensive perioperative service that is central to pediatric cardiac surgical care and hospital operating room resource planning. Nationally, it represents a critical component of bundled surgical and facility case costing and is relevant to payer policy for high-complexity pediatric cardiac procedures.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare and Medicare. Readers will find an overview of clinical context for the code, typical sites of service, common billing considerations, and the types of benchmarks and policy elements payers commonly evaluate for high-acuity pediatric anesthesia services. The publication highlights expected use cases for CPT code 00561, implications for hospital and anesthesiology department billing lines, and the role this code plays in payer authorization and reimbursement frameworks.
Data not available in the input: associated taxonomies, ICD-10 diagnoses, related codes, and service line details.
Billing Code Overview
CPT code 00561 describes anesthesia services for infants younger than one year undergoing cardiac and great vessel surgery that requires use of a pump oxygenator (cardiopulmonary bypass). The service involves management of anesthesia for procedures on the heart, the sac around the heart (pericardium), the aorta and its major branches, and the major pulmonary vessels.
Service type: Cardiac anesthesia with cardiopulmonary bypass for infants (<1 year)
Typical site of service: Inpatient operating room, pediatric cardiac surgical suite, or cardiac catheterization lab within a hospital setting
Clinical & Coding Specifications
Clinical Context
A term infant under 1 year of age with critical congenital heart disease (for example, transposition of the great arteries or hypoplastic left heart syndrome) is scheduled for corrective intracardiac surgery requiring cardiopulmonary bypass with a pump oxygenator. Preoperative workflow includes multidisciplinary evaluation by pediatric cardiology, cardiothoracic surgery, and pediatric anesthesia. On the day of surgery the patient is transported to a pediatric cardiac operating room/lor with intraoperative transesophageal echocardiography availability. The anesthesia team performs pre-induction checklists, secures intravenous access (and often arterial and central venous lines), induces general anesthesia, places an endotracheal tube, and provides full intraoperative anesthetic management during sternotomy, cannulation, initiation and management of cardiopulmonary bypass, and separation from bypass. Post-bypass care includes hemodynamic stabilization, pain control, and coordination of transfer to the pediatric cardiac intensive care unit for ventilatory and vasoactive support and ongoing monitoring.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally provided the anesthesia for this procedure |
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