CPT 01214: Anesthesia for Open Total Hip Arthroplasty
CPT code 01214 denotes anesthesia services for open total hip arthroplasty, a common major orthopedic procedure. This code is used nationally to classify perioperative anesthetic care for patients undergoing total hip replacement via an open surgical approach, capturing the complexity and resource intensity of anesthesia for major joint reconstruction. Accurate use of this code affects clinical documentation, facility billing, and payer adjudication for high-acuity surgical anesthesia services.
Key payers in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise explanation of the code’s clinical context and service setting, guidance on common billing considerations, and comparisons to related procedural coding such as the hip arthroplasty surgical code. The publication also outlines typical payer coverage patterns and coding relationships relevant to anesthesia professionals, perioperative teams, and billing staff.
This summary provides national-level context for clinicians and administrators seeking clarity on the purpose of CPT code 01214, how it aligns with surgical service lines, and what elements of care it represents for anesthesia practice in major orthopedic procedures.
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Billing Code Overview
CPT code 01214 describes anesthesia services provided for a patient undergoing an open total hip arthroplasty. The service type is anesthesia for major orthopedic surgery. The typical site of service is an inpatient or ambulatory surgical setting where open total hip arthroplasty (arthroplasty of the hip) is performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with advanced osteoarthritis presents for an open total hip arthroplasty. The preoperative assessment by the anesthesia team documents controlled hypertension, type 2 diabetes, and prior right knee arthroplasty. The patient is evaluated in preop clinic by an anesthesiologist or certified registered nurse anesthetist (CRNA) using airway assessment, review of medications, and perioperative risk stratification (ASA physical status P3). On the day of surgery, regional anesthesia (spinal or neuraxial) with sedation or general endotracheal anesthesia is administered depending on surgical and patient factors. Intraoperative anesthetic management includes airway management, invasive and noninvasive monitoring, fluid management, hemodynamic support, blood loss management, and postoperative analgesia planning (nerve block, multimodal analgesia). Postoperative handoff is provided to PACU staff with instructions for pain control, anticoagulation timing, and mobilization. Documentation includes the anesthesia start and end times, type of anesthesia, monitored parameters, medications administered, any anesthetic complications, and modifiers as applicable for unusual circumstances (for example, additional complexity, multiple anesthetists, or assistant involvement).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia care required substantially greater resources or complexity than usual, documented with justification. |
23 | Unusual anesthesia | Use when general anesthesia is administered for a procedure that ordinarily does not require it, with documentation. |
50 | Bilateral procedure | Use when identical procedures are performed on both hips during the same operative session. |
52 | Reduced services | Use when anesthesia services are partially reduced or a planned component is not completed. |
53 | Discontinued procedure | Use when anesthesia administration is started but the procedure is terminated without completion for documented reasons. |
62 | Two surgeons | Use when two surgeons perform distinct surgical parts requiring shared operative responsibilities; may affect anesthesia documentation for prolonged or complex cases. |
78 | Unplanned return to the operating room following initial procedure for related procedure during the postoperative period | Use when patient returns to OR for a related anesthetic within the global period. |
AA | Anesthesia by an anesthesiologist | Use to indicate the anesthesiologist personally performed the anesthesia service. |
QK | Medical direction of two, three, or four CRNAs/Anesthetists | Use when an anesthesiologist medically directs multiple CRNAs for services rendered. |
QS | Monitored anesthesia care service | Use when monitored anesthesia care is provided rather than general or regional anesthesia. |
QX | CRNA service with medical direction by a physician | Use when a CRNA performs the service under physician medical direction. |
QY | Medical direction of one CRNA by an anesthesiologist | Use when an anesthesiologist directs one CRNA. |
QZ | CRNA service without medical direction by a physician | Use when a CRNA provides services independently. |
AD | Medical supervision by a physician; more than four concurrent anesthesia procedures | Use when supervising anesthesiologist oversees more than four concurrent cases. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists performing preoperative evaluation and intraoperative management. |
207LA0401X | Pain Medicine (Anesthesiology) | Anesthesiologists with subspecialty focus on perioperative pain management and regional analgesia techniques. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs providing anesthesia services in hospitals and ambulatory surgical centers. |
367H00000X | Anesthesiologist Assistant | Anesthesiologist assistants working under anesthesiologist supervision for intraoperative management. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M17.10 | Unilateral primary osteoarthritis, unspecified knee | Osteoarthritis of the knee may coexist in patients undergoing hip arthroplasty and affect perioperative mobilization and rehabilitation planning. |
M17.11 | Unilateral primary osteoarthritis, right knee | Documented right knee osteoarthritis is relevant to overall joint disease burden and postoperative mobility expectations. |
M17.12 | Unilateral primary osteoarthritis, left knee | Documented left knee osteoarthritis informs rehabilitation and assistive device needs after hip arthroplasty. |
M17.5 | Other unilateral secondary osteoarthritis of knee | Secondary osteoarthritis from prior injury or disorder may influence perioperative risk and functional recovery. |
Z96.651 | Presence of right artificial knee joint | Indicates prior right knee arthroplasty; relevant for positioning, vascular access, and fall-risk assessment. |
Z96.652 | Presence of left artificial knee joint | Indicates prior left knee arthroplasty; relevant for postoperative mobilization and prosthesis precautions. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
27130 | Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty) | Primary surgical procedure for which anesthesia code 01214 is reported; anesthesia services are keyed to the operative procedure. |