Summary & Overview
CPT 01390: Anesthesia for Closed Procedures of Upper Tibia/Fibula/Patella
CPT code 01390 designates anesthesia services for any closed procedure involving the upper end of the tibia, fibula, and/or the patella. This code captures perioperative anesthesia care for closed knee-region interventions such as closed reductions, arthroscopic maneuvers that address the upper tibia/patella region, and other non‑open procedures focused on the proximal tibia/fibula or patella. It matters nationally because anesthesia billing for musculoskeletal procedures constitutes a substantial portion of perioperative service claims and influences facility staffing, resource allocation, and anesthesia practice patterns.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, United Healthcare, and Medicare. Readers will find a concise overview of the code's clinical scope and billing context, comparisons to related anesthesia codes for knee and popliteal area procedures, and the typical settings where this service is furnished. The publication highlights common diagnostic contexts such as primary osteoarthritis, medial collateral ligament sprains, and chronic knee instability that often accompany use of this code. It also notes related CPT anesthesia codes for diagnostic arthroscopy and open procedures of the same anatomic region to clarify coding distinctions. The content is intended to inform coding staff, revenue leaders, and clinicians about clinical applicability, coding relationships, and the payer mix relevant to national billing practices.
Billing Code Overview
CPT code 01390 describes anesthesia services provided for a patient undergoing any closed procedure of the upper end of the tibia, fibula, and/or the patella. This service typically supports procedures focused on the knee region, performed without creating an open surgical wound.
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Service type: Anesthesia for closed procedures of the upper tibia/fibula/patella
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Typical site of service: Hospital operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with chronic right knee pain from longstanding primary osteoarthritis (M17.11) presents for an orthopedic closed procedure addressing tibial plateau subchondral cyst debridement and percutaneous fixation of an associated tibial fracture fragment. Preoperative evaluation by the anesthesia team documents medical history, medications, airway assessment, and ASA physical status P2 for controlled hypertension. The patient is brought to an ambulatory surgery center (typical site of service) where the orthopedist performs a closed reduction and percutaneous fixation of the upper tibia and patella fragment under fluoroscopic guidance. The anesthesia provider (an anesthesiologist or Certified Registered Nurse Anesthetist) administers monitored general anesthesia with endotracheal intubation and intraoperative hemodynamic management, including regional block supplementation as indicated. Postoperative handoff includes documentation of anesthesia technique, intraoperative events, estimated blood loss, and postoperative pain plan before transfer to the PACU for recovery and same-day discharge if stable.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
23 | Unusual Anesthesia | Use when emergency conditions require general anesthesia for a procedure usually done with local/monitored anesthesia. |