Summary & Overview
CPT 01202: Anesthesia for Arthroscopic Hip Procedure
CPT code 01202 denotes anesthesia services provided for arthroscopic procedures of the hip joint. As a procedure-specific anesthesia code, it facilitates billing for intraoperative anesthetic management during minimally invasive hip surgeries. Accurate use of this code is important for claims processing, provider reimbursement, and national tracking of anesthesia utilization for orthopedic arthroscopy.
Key payers addressed in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. The publication reviews payer coverage patterns, common claim-level modifiers, and clinical context surrounding arthroscopic hip procedures to support correct coding and coding consistency across payers.
Readers will find a concise overview of clinical indications for arthroscopic hip surgery, typical sites of service (hospital operating room and ambulatory surgery center), and related procedural context. The document also presents expected payer-specific considerations, common modifiers used with anesthesia services, and links to related orthopedic and anesthesia procedure codes for clinical correlation. This national-focused summary aims to clarify the code's clinical scope and billing context without state-specific policy detail. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 01202 describes anesthesia services furnished for a patient undergoing an arthroscopic procedure of the hip joint. This code represents the anesthesia component of care provided during minimally invasive, camera-assisted hip joint surgery.
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Service type: Anesthesia for arthroscopic hip procedure
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 55-year-old male presents with progressive right shoulder pain and weakness after a fall. Imaging demonstrates a suspected rotator cuff tear and subacromial impingement. The orthopedic surgeon schedules an arthroscopic shoulder procedure to evaluate and repair the rotator cuff and perform subacromial decompression if indicated. The anesthesia team provides general endotracheal anesthesia with an interscalene nerve block for perioperative analgesia. Preoperative evaluation documents ASA classification P2, relevant comorbidities, airway assessment, and informed consent for anesthesia. Intraoperative monitoring includes ECG, blood pressure, pulse oximetry, end-tidal CO2, and temperature. The anesthesiologist documents anesthetic start and stop times, regional block performance, any intraoperative complications (for example hypotension or unexpected severe bleeding), and post-anesthesia condition for handoff to PACU. Typical postoperative workflow includes PACU monitoring, opioid-sparing analgesia facilitated by the regional block, and discharge planning with activity and pain control instructions provided by the surgical team.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia services require substantially greater work due to complexity, documented and justified in the anesthesiology record. |