Summary & Overview
CPT 01420: Anesthesia for Cast Involving Knee Joint
CPT code 01420 denotes anesthesia services provided when a patient undergoes application, removal, or repair of a cast that includes the knee joint. This code captures anesthesia care tied to orthopedic casting procedures involving the knee and is relevant for billing, care coordination, and procedure-level quality measurement across inpatient and ambulatory surgical settings. Nationally, accurate use of the code affects payment integrity, anesthesia staffing, and perioperative reporting for knee-related orthopedic care.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The analysis covers payer coverage conventions and typical site-of-service considerations for anesthesia billed with cast procedures involving the knee.
Readers will find: an overview of the clinical context for anesthesia during knee-including cast procedures; guidance on common billing relationships and related orthopedic procedure codes for clinical correlation; and a summary of typical payer coverage patterns and documentation considerations. The content helps coding, billing, and clinical teams align anesthesia service reporting with procedural care for knee casting without offering treatment recommendations. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 01420 describes anesthesia services for application, removal, or repair of a cast that includes the knee joint. The service involves administration and management of anesthesia during procedures specifically addressing casting that involves the knee.
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Service type: Anesthesia for cast application, removal, or repair involving the knee joint
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Typical site of service: Hospital operating room, ambulatory surgical center, or other procedural setting where anesthesia services are delivered for orthopedic casting involving the knee joint
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with progressive right knee pain from unilateral primary osteoarthritis (M17.11) presents for total knee arthroplasty. Intraoperative management requires general endotracheal anesthesia with a peripheral nerve block for postoperative analgesia. The anesthesia provider is billed under 01420 when anesthesia services are performed for application or removal of a cast that includes the knee joint (for example, when a postoperative immobilizing cast or brace that encompasses the knee must be applied, adjusted, or removed in the perioperative period). Typical workflow: preoperative evaluation by the anesthesia team, documentation of medical comorbidities and ASA physical status (e.g., P3), performance of neuraxial or general anesthesia and any peripheral nerve block, coordination with orthopedics for cast application or removal in the operating room or procedure suite, monitoring during the procedure, and immediate postoperative handoff in PACU. Services may occur in an ambulatory surgery center, hospital outpatient department, or inpatient operating room depending on the primary surgical procedure and patient status.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services |