CPT 00752: Anesthesia for Upper Abdominal Hernia Repair
CPT code 00752 designates anesthesia services for upper abdominal hernia repairs, including lumbar, ventral, incisional hernias, and wound dehiscence. This anesthetic classification is important nationally because it captures perioperative care resource use and billing for a common set of abdominal wall procedures that vary in complexity and patient risk. Accurate reporting of 00752 affects payment, quality measurement, and procedural case mix documentation across hospital and ambulatory surgical settings.
Key payers in this review include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find an explanation of the clinical context for anesthesia delivery for upper abdominal hernia repairs, how this code relates to neighboring CPT anesthesia codes, and typical sites of service. The publication outlines common billing considerations, common associated diagnosis contexts for these procedures, and related anesthesia CPT codes used for upper abdominal hernia repairs.
This summary provides national-level guidance on what CPT code 00752 represents, who covers it, and what elements to expect in a billing and clinical documentation review. It is intended to inform billing administrators, anesthesiology departments, and policy analysts about the code’s clinical scope and relevance in perioperative billing workflows.
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Billing Code Overview
CPT code 00752 describes anesthesia services provided for hernia repairs in the upper abdomen, including lumbar and ventral or incisional hernias and wound dehiscence. The service type is anesthesia for surgical repair of upper abdominal hernias. The typical site of service is the operating room or other procedural/surgical setting where general, regional, or monitored anesthesia care is delivered for abdominal wall hernia repair.
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents with progressive upper abdominal pain and a symptomatic ventral/incisional hernia after prior laparotomy. He reports intermittent dysphagia (R13.10) and throat pain (R07.0) but the primary surgical indication is a painful, enlarging incisional hernia with localized bowel entrapment suspected on exam and imaging. The surgical team plans an open repair of an upper abdominal ventral/incisional hernia under general anesthesia with endotracheal intubation. The anesthesiology team evaluates the patient in preoperative holding, documents airway assessment, ASA physical status (P3), relevant comorbidities, and perioperative risks related to possible esophageal disease (K22.2, K22.8). Intraoperative care includes induction, airway management, hemodynamic monitoring, maintenance of anesthesia, analgesia, and emergence. Postoperative handoff to PACU addresses airway concerns, pain control, nausea/vomiting prophylaxis, and instructions for wound monitoring given the repair and potential for wound dehiscence. If intraoperative complexity increases (extensive adhesiolysis or unplanned visceral repair), a modifier such as 22 may be applied to reflect increased procedural service intensity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when intraoperative work is substantially greater than typical for 00752 (extensive adhesiolysis, prolonged difficult repair). |
23 | Unusual anesthesia | Use when general anesthesia is medically contraindicated and an unusual anesthesia circumstance occurs. |
47 | Anesthesia by surgeon | Use if the surgeon performs anesthesia services, meeting payer rules. |
50 | Bilateral procedure | Use when bilateral simultaneous hernia repairs are performed in same operative session. |
52 | Reduced services | Use when the procedure is partially reduced or abbreviated for clinical reasons. |
53 | Discontinued procedure | Use when procedure is terminated due to extenuating circumstances (e.g., unexpected instability). |
62 | Two surgeons | Use when two surgeons are required for distinct portions of repair. |
78 | Return to OR for related procedure following initial anesthesia | Use for anesthesia during an unplanned return to the operating room for a related procedure. |
AA | Anesthesia services performed personally by anesthesiologist | Use when an anesthesiologist personally performs the anesthesia. |
AD | Medical supervision by anesthesiologist; more than four concurrent anesthesia procedures | Use when supervising CRNAs for more than four concurrent cases. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery (note: limited applicability to anesthesia billing) | Use when an advanced practice provider assists in perioperative management per payer allowance. |
QK | Medical direction of two to four anesthetists | Use when the anesthesiologist medically directs multiple CRNAs for this case. |
QS | Monitored anesthesia care (MAC) service | Use if MAC is performed instead of general anesthesia for an appropriate repair. |
QX | CRNA service with anesthesia direction by a physician | Use when a CRNA furnishes the anesthesia and a physician directs. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology Physician | Performs or medically directs anesthesia for upper abdominal hernia repairs. |
367500000X | Certified Registered Nurse Anesthetist | Provides anesthesia services, may perform under direction or supervision. |
207RA0000X | Critical Care Medicine Physician | Consults or manages perioperative critical care for high-risk patients; documents involvement when applicable. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
K22.2 | Esophageal obstruction | Relevant when esophageal pathology contributes to swallowing symptoms or impacts airway/aspiration risk during anesthesia for upper abdominal hernia repair. |
K22.8 | Other specified diseases of esophagus | Captures other esophageal conditions that may affect perioperative airway management or increase aspiration risk. |
K22.9 | Disease of esophagus, unspecified | Used when esophageal disease is present but not further specified; relevant to anesthetic risk assessment. |
R13.10 | Dysphagia, unspecified | Symptom that may indicate impaired swallowing and aspiration risk; influences anesthetic planning and airway protection. |
R07.0 | Pain in throat | Symptom potentially associated with esophageal disease or preexisting irritation that is part of the clinical picture during preoperative assessment. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
00750 | Anesthesia for hernia repairs in upper abdomen; not otherwise specified | Alternative primary anesthesia code for upper abdominal hernia repairs when specific subtype of 00752 is not applicable. |
00754 | Anesthesia for hernia repairs in upper abdomen; omphalocele | Use when the hernia repair is for an omphalocele rather than a lumbar/ventral/incisional hernia. |
00756 | Anesthesia for hernia repairs in upper abdomen; transabdominal repair of diaphragmatic hernia | Use when the repair involves a transabdominal diaphragmatic hernia rather than the lumbar/ventral/incisional hernias described by 00752. |