Summary & Overview
CPT 01260: Anesthesia for Veins of Upper Leg, Including Exploration
CPT code 01260 identifies anesthesia services for procedures on the veins of the upper leg, including exploration. This code is used to document the anesthesiologist’s role in providing perioperative anesthesia care specific to venous surgery of the upper thigh. Nationally, accurate use of this code supports appropriate clinical documentation, claims processing, and a standardized record of anesthesia complexity tied to limb vascular procedures.
Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of where CPT code 01260 applies clinically, how it relates to nearby anesthesia codes for upper-leg procedures, and the typical settings in which the service is delivered. The publication summarizes common modifiers and related codes for cross-reference, highlights associated clinician taxonomies, and lists relevant ICD-10 diagnoses seen with upper-leg venous procedures.
This report is intended for national audiences including billing professionals, anesthesiology clinicians, revenue cycle managers, and policy analysts seeking a clear, practice-focused description of CPT code 01260, its clinical context, and operational considerations.
Billing Code Overview
CPT code 01260 describes anesthesia services provided for a patient undergoing a procedure on the veins of the upper leg, including exploration. This code indicates that the clinician administers and manages anesthesia care specific to venous surgical procedures in the upper thigh region.
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Service type: Anesthesia for venous surgery of the upper leg, including exploration
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Typical site of service: Operating room or surgical suite where venous procedures of the upper leg are performed
Clinical & Coding Specifications
Clinical Context
A 62-year-old male presents with progressive pain and swelling localized to the medial thigh and upper leg after a fall and progressive venous insufficiency. Imaging demonstrates thrombosed varicosities and a ruptured superficial vein requiring surgical exploration and repair of the veins of the upper leg. The patient has a history of controlled hypertension and well-managed type 2 diabetes mellitus. The vascular surgeon plans open exploration and repair of the affected upper leg veins under general endotracheal anesthesia with peripheral nerve block supplementation for postoperative analgesia.
Preoperative workflow includes anesthesia preoperative evaluation, consent for anesthesia risks, review of recent labs and anticoagulation status, medication reconciliation, and placement of standard ASA monitors in the operating room. Anesthesia services include induction of general anesthesia, airway management, maintenance of anesthesia, intraoperative hemodynamic management, and regional block placement as indicated. Postoperative handoff includes recovery room vigilance for bleeding, hemodynamic stability, pain control, and assessment of neurovascular status of the limb.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When documented work or complexity of anesthesia care exceeds typical and supports increased payment for prolonged or unusually complex anesthesia for upper leg venous exploration. |