CPT 01652: Anesthesia for Axillary–Brachial Artery Aneurysm Surgery
CPT code 01652 designates anesthesia services for surgical procedures addressing an axillary–brachial artery aneurysm. This code captures anesthetic management for vascular surgery involving the axillary and brachial arterial segments and is used in billing for operative anesthesiology care in hospital operating rooms and surgical suites. Nationally, codes for specialized vascular anesthesia are important for capturing case complexity, resource use, and provider specialty involvement.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise description of clinical context, payer coverage considerations, and how 01652 aligns with related anesthesia codes for shoulder and axillary arterial procedures.
The publication provides benchmarks for where 01652 sits among related anesthesia codes, outlines typical clinical scenarios that generate this code, and summarizes common billing considerations and service settings. The content is structured to support coding staff, anesthesiology departments, and revenue teams seeking a national-level reference for the use and classification of CPT code 01652 in perioperative vascular care.
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Billing Code Overview
CPT code 01652 describes anesthesia services provided for a patient undergoing surgery to repair or manage an axillary–brachial artery aneurysm. The service involves perioperative anesthetic care tailored to vascular surgery of the axillary and brachial arterial segments.
Service Type: Anesthesia for arterial surgery of the shoulder/axilla region
Typical Site of Service: Hospital operating room or surgical suite (inpatient or outpatient) where vascular surgery is performed
Clinical & Coding Specifications
Clinical Context
A 68-year-old male with a history of peripheral arterial disease and hypertension presents with an enlarging axillary–brachial artery aneurysm identified on duplex ultrasound and CT angiography. The vascular surgery team schedules elective open repair with aneurysm resection and interposition grafting under general anesthesia. Preoperative evaluation in the pre-anesthesia clinic documents ASA physical status P4 due to severe systemic disease and antiplatelet therapy. The anesthesia team (anesthesiologist or CRNA under medical direction) performs standard monitors, arterial line placement for continuous invasive blood pressure monitoring, large-bore IV access, and induction of general endotracheal anesthesia. Intraoperative management includes heparinization per surgical protocol, blood loss replacement, and potential conversion to a regional block for postoperative analgesia. Postoperative care includes transfer to the PACU with continued hemodynamic monitoring and pain control. Documentation includes start and stop times for anesthesia, airway management details, invasive monitoring, administered medications, estimated blood loss, fluids and blood products, and any intraoperative complications or unplanned events requiring modifier reporting.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when anesthesia services involved substantially greater work than typical, documented and justified (e.g., unusually prolonged anesthesia due to complex vascular exposure). |
23 | Unusual anesthesia | Use when general anesthesia is administered for a procedure that normally does not require it, if applicable. |
50 | Bilateral procedure | Use if identical procedures are performed bilaterally on the axilla/shoulder region (rare for this code). |
52 | Reduced services | Use when planned anesthesia is partially reduced or a portion of the service not performed. |
53 | Discontinued procedure | Use when anesthesia is terminated due to patient instability or intraoperative cancellation. |
54 | Surgical care only | Not typically appended to anesthesia claims; included for situations where anesthesia services are billed separately from surgical care transitions. |
62 | Two surgeons | Use when two surgeons independently perform distinct parts of the operation; may affect billing relationships. |
78 | Return to OR for related procedure | Use when patient returns to the operating room for a related procedure during the global period. |
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally performs the anesthesia. |
QK | Medical direction of two, three, or four C.R.N.A.s by a physician | Use when the anesthesiologist medically directs multiple CRNAs for the case. |
QX | CRNA service: CRNA with medically directed services | Use when a CRNA performs the anesthesia under medical direction. |
QS | Monitored anesthesia care service | Use when monitored anesthesia care rather than general anesthesia is provided. |
FY | Retroactive Audit Adjustment | Use when payor requires a specific modifier for claim adjustments per contract terms. |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | Use when the physician supervises more than four concurrent anesthesia cases. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology | Physician anesthesiologists who provide preoperative assessment, general/regional anesthesia, and intraoperative management. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who may deliver anesthesia services, often under supervision or direction of an anesthesiologist. |
207LA0401X | Pain Medicine (Anesthesiology) | Anesthesiologists with pain medicine training who may be involved in regional blocks or postoperative pain plans. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S82.101A | Unspecified fracture of right tibia, initial encounter for closed fracture | Not directly related to axillary–brachial aneurysm repair; may represent a concurrent traumatic injury affecting perioperative risk and positioning. |
M25.571 | Pain in right ankle and joints of right foot | Peripheral pain diagnoses unrelated to axillary–brachial aneurysm repair; may affect perioperative pain management plans. |
M79.671 | Pain in right foot | Non-specific musculoskeletal pain that may be part of the patient's comorbid presentation and analgesic needs. |
S93.401A | Sprain of unspecified ligament of right ankle, initial encounter | Additional musculoskeletal injury that can influence preoperative mobility and postoperative rehabilitation. |
M25.572 | Pain in left ankle and joints of left foot | Contralateral ankle pain; included in the record as comorbidity potentially affecting postoperative care and mobility. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01650 | ANESTHESIA ARTERIES SHOULDER & AXILLA NOS | Alternative code for anesthesia services to the shoulder/axilla region when aneurysm-specific code not used; may be used for less specific procedures. |
01654 | ANES ARTERIES SHOULDER & AXILLA BYPASS GRAFT | Used when the surgical procedure is axillary–brachial bypass grafting rather than aneurysm resection; anesthesia coding differs based on operative detail. |
01656 | ANESTHESIA AXILLARY-FEMORAL BYPASS GRAFT | Used when an axillary–femoral bypass graft is performed; indicates a different operative field and potential anesthetic considerations. |
01670 | Anesthesia for all procedures on veins of shoulder and axilla | Used when the procedure involves venous operations in the shoulder/axilla region rather than arterial procedures; differentiates vascular bed for anesthesia coding. |