CPT 01140: Anesthesia for Interpelviabdominal Amputation
CPT code 01140 denotes anesthesia services for an interpelviabdominal amputation, a major surgical procedure removing one half of the pelvis and one entire lower limb. Nationally, this code represents high-complexity intraoperative anesthesia care for rare but resource-intensive oncologic or trauma-related amputations. It is relevant to anesthesiology practices, hospital perioperative teams, and payers managing high-acuity surgical episodes. Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for the procedure, comparisons to related anesthesia codes for pelvic and lower-extremity operations, and operational considerations for billing and coding for high-complexity amputations. The publication outlines coding relationships to adjacent CPT anesthesia codes for pelvic procedures, highlights typical sites of service and service type, and summarizes payer coverage landscape and common modifier usage. This overview serves clinicians, coding professionals, and revenue cycle stakeholders seeking concise guidance on the clinical scope and billing context of CPT code 01140 at a national level.
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Billing Code Overview
CPT code 01140 describes anesthesia services provided for an interpelviabdominal amputation, a surgical procedure that removes one half of the pelvis and one entire lower limb. This service represents anesthesia management for a high-complexity, major amputation involving both pelvic and lower-extremity structures.
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Service type: Major intra-abdominal and pelvic amputation with lower-extremity resection
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Typical site of service: Inpatient operating room or specialized surgical suite for major amputative surgery
Clinical & Coding Specifications
Clinical Context
A 62-year-old male with end-stage degenerative disease and prior traumatic injury to the right lower extremity presents for a planned interpelviabdominal (hindquarter) amputation due to intractable pain, recurrent infection, and nonviable pelvic hemipelvis following tumor resection and chronic osteoarthritic degeneration of both knees. The patient has a history of unilateral primary osteoarthritis of the right knee (M17.11) and left knee (M17.12), prior medial collateral ligament sprains (S83.241A, S83.242A), and chronic knee instability (M23.50), contributing to overall functional decline.
The clinical workflow begins with preoperative evaluation by the surgical oncology and orthopedic teams, anesthesiology preoperative assessment with airway and hemodynamic risk stratification, and optimization of comorbidities. On the day of surgery in an inpatient operating room setting, the anesthesia team (anesthesiologist or CRNA with anesthesiology attending supervision) provides general anesthesia with invasive monitoring, major fluid and blood-product management, arterial line and central venous access as indicated, and postoperative acute pain planning. Intraoperative responsibilities include induction, maintenance of anesthesia, hemodynamic stabilization during major vascular control and transfusion, and coordination with the surgical team for positioning and ischemia management. Postoperative handoff to the intensive care unit or high-acuity recovery unit occurs for continued hemodynamic monitoring, ventilatory support as needed, and pain control.
Coding Specifications
- This section lists the most clinically relevant modifiers for anesthesia services for interpelviabdominal amputation (
01140) and describes typical use.
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when intraoperative anesthesia management required substantially greater work or time due to complexity (document reasons and time). |
23 | Unusual anesthesia | Use when anesthesia is medically contraindicated but required for emergency or unusual circumstances (document medical contraindication). |
50 | Bilateral procedure | Not typically applicable to unilateral hindquarter amputation; include only if bilateral procedures performed concurrently. |
52 | Reduced services | Use when anesthesia services are partially reduced or curtailed (document reason, e.g., procedure aborted). |
53 | Discontinued procedure | Use when the anesthesia was provided but the surgical procedure was terminated prior to completion. |
54 | Surgical care only | Apply when the anesthesiologist provides only the surgical anesthesia and transfers postoperative care to another physician. |
55 | Postoperative management only | Use when the anesthesiologist provides only postoperative pain management and not intraoperative services. |
56 | Preoperative management only | Use when the anesthesiologist provides only preoperative evaluation and management. |
62 | Two surgeons | Use when two surgeons of different specialties perform distinct portions of the operation; impacts operative complexity but may be reported when relevant to anesthesia documentation. |
78 | Unplanned return to operating room following initial procedure | Use when the patient returns to the OR for a related anesthetic for a complication or revision during the global period. |
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally performs the anesthesia services. |
AD | Medical supervision by a physician; more than four concurrent anesthesia procedures | Use when the physician supervises multiple concurrent anesthesia procedures per CMS rules. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for qualified nonphysician anesthetist | Use when these practitioners furnish anesthesia services in states and settings where allowed and documented. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists provide primary anesthesia services for major amputations and complex pelvic procedures. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs commonly deliver anesthesia care, often under supervision or medical direction protocols. |
207RA0401X | Anesthesiology Assistant | Anesthesiology assistants may participate under physician supervision for intraoperative management and monitoring. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.11 | Unilateral primary osteoarthritis, right knee | Degenerative joint disease contributing to limited mobility and may factor into limb salvage decisions leading to major amputation. |
M17.12 | Unilateral primary osteoarthritis, left knee | Bilateral knee osteoarthritis affects functional status and surgical planning for major pelvic-limb procedures. |
S83.241A | Sprain of medial collateral ligament of right knee, initial encounter | Prior ligamentous injury may contribute to chronic instability and failed reconstructive options, influencing decision for amputation. |
S83.242A | Sprain of medial collateral ligament of left knee, initial encounter | Contralateral ligament injury that impacts overall limb function and reconstruction candidacy. |
M23.50 | Chronic instability of knee, unspecified knee | Chronic instability can lead to repeated injuries, pain, and impaired function that contribute to the indication for radical amputation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01150 | Anesthesia for radical procedures for tumor of pelvis, except hindquarter amputation | Alternative pelvic anesthesia code used for radical pelvic tumor procedures; considered when procedure differs from hindquarter amputation in extent. |
01120 | Anesthesia for procedures on bony pelvis | Related anesthesia code for non-hindquarter pelvic procedures; may be used for less extensive pelvic bony procedures or combined procedures where 01140 is not appropriate. |