CPT 01712: Anesthesia for Open Tenotomy, Elbow to Shoulder
CPT code 01712 represents anesthesia services for an open tenotomy performed in the upper extremity, encompassing procedures from the elbow to the shoulder. This code captures perioperative anesthesia care specific to open surgical release or lengthening of tendons in that anatomical region. Nationally, accurate use of this code matters for correct reporting of anesthesia services associated with upper-extremity orthopedic surgery, supporting appropriate clinical documentation and payer adjudication.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage patterns and billing context across major national payers, common claim considerations, and how 01712 relates to other anesthesia codes for extremity procedures. The publication outlines clinical context for open tenotomy procedures, typical sites of service, and related anesthesia service lines. It also identifies frequently used modifiers and related anesthesia procedure codes for upper- and lower-extremity care to help clarify coding relationships.
This executive summary provides a concise reference for billing managers, anesthesia providers, and revenue-cycle professionals seeking a national perspective on coding and classification for anesthesia during open tenotomy of the elbow-to-shoulder region. Data not available in the input is noted where applicable elsewhere in the full publication.
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Billing Code Overview
CPT code 01712 describes anesthesia services provided for an open tenotomy performed on the upper extremity, specifically from the elbow to the shoulder. The service type is anesthesia for an open tenotomy of the arm/shoulder region. The typical site of service is an operating room or other surgical suite where open upper-extremity orthopedic procedures are performed, such as hospital outpatient departments or ambulatory surgery centers.
Clinical & Coding Specifications
Clinical Context
A 45-year-old male presents to the orthopedic surgery clinic with chronic lateral elbow pain and a tendon injury requiring an open tenotomy between the elbow and shoulder region. Preoperative evaluation identifies localized tendon pathology and persistent functional impairment after conservative care. The patient is scheduled for an open tenotomy of the distal biceps tendon performed in an ambulatory surgery center under general anesthesia with regional block for postoperative analgesia. The perioperative workflow includes pre-anesthesia evaluation by the anesthesiology team, informed consent for anesthesia, intraoperative monitoring per ASA standards, airway management and induction, maintenance of general anesthetic with supplemental peripheral nerve block (if indicated), intraoperative hemodynamic management, and postoperative transfer to the PACU for recovery and pain control prior to discharge or inpatient admission as directed by the surgical and anesthesia teams. Typical documentation includes the anesthesia preoperative assessment, ASA physical status, airway and vascular access notes, anesthetic technique (agents, doses), regional block details if performed, intraoperative events, and postoperative disposition.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when the anesthesia service required substantially greater work or complexity than typical for 01712 (document justification). |
23 | Unusual anesthesia | Use when general anesthesia is administered for a procedure that is normally performed with local or monitored anesthesia care; document reason. |
50 | Bilateral procedure | Use when identical procedures are performed on both sides in the same session (rare for upper-extremity tenotomy but included if applicable). |
52 | Reduced services | Use when the anesthesia service is partially reduced or not completed as planned. |
53 | Discontinued procedure | Use when the anesthetic is terminated because the procedure was halted for documented medical reasons. |
59 | Distinct procedural service | Use to indicate a separate anesthesia-related service that is distinct and unrelated to another billed service on the same day. |
62 | Two surgeons | Use when two surgeons work together as primary surgeons during the operative procedure (affects surgical coding; documented if applicable). |
78 | Unplanned return to the operating/procedure room by the same physician following initial procedure for related procedure during the postop period | Use when the patient returns to the OR for a related anesthetized procedure after the initial 01712 session. |
AA | Anesthesia services performed personally by anesthesiologist | Use to indicate services personally performed by an anesthesiologist. |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | Use when the anesthesiologist provides medical direction/supervision for multiple concurrent cases exceeding usual limits. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for anesthesia | Use when qualified non-physician anesthesia professional provides the service under supervision as defined by payer rules. |
QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified CRNAs | Use when the anesthesiologist medically directs multiple concurrently administered CRNA-managed cases. |
QX | CRNA service: CRNA with medical direction by a physician | Use when a CRNA performs the anesthesia service under physician medical direction. |
QS | Monitored anesthesia care service | Use when monitored anesthesia care rather than general anesthesia is provided for the procedure (documented). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207L00000X | Anesthesiology Physician | Physician specialists who provide or medically direct anesthesia care for 01712. |
367500000X | Certified Registered Nurse Anesthetist | CRNAs who may perform anesthesia services for this procedure, with applicable modifier reporting. |
207RA0401X | Anesthesiology Assistant | Anesthesiology assistants who assist anesthesiologists in perioperative management; documentation should reflect role and supervision. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M25.571 | Pain in right ankle and joints of right foot | Included in dataset; may represent concurrent lower-extremity pain but not typically directly related to an upper-arm open tenotomy. Document relevance if billed with 01712. |
M25.572 | Pain in left ankle and joints of left foot | Included in dataset; similar note regarding anatomic mismatch with 01712 unless multiple sites are addressed. |
M79.671 | Pain in right foot | Dataset inclusion; document clinical correlation if both upper and lower extremity complaints are present. |
M79.672 | Pain in left foot | Dataset inclusion; document clinical correlation if applicable. |
S93.401A | Sprain of unspecified ligament of right ankle, initial encounter | Included in dataset; primarily a lower-extremity traumatic diagnosis and not typically the primary indication for an open tenotomy of the elbow-to-shoulder area unless the anesthetic encounter includes multiple procedures or the chart documents multiple injury sites. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
01462 | Anesthesia for procedures on lower leg, knee joint | Related regional anesthesia coding for lower-extremity procedures; included here as a referenced alternative region-specific anesthesia code when procedures involve lower extremity rather than upper arm/shoulder. |
01464 | Anesthesia for open or surgical arthroscopic procedures on knee joint | Represents anesthesia coding for knee arthroscopy; included for cross-reference to common extremity procedure anesthesia codes. |
01470 | Anesthesia for procedures on bones of lower leg, ankle, and foot | Codes anesthesia for foot/ankle surgeries; provided as related extremity anesthesia codes in the dataset for comparator use. |
01480 | Anesthesia for procedures on nerves, muscles, tendons, fascia, and bursae of knee and popliteal area | Related anesthesia coding for tendon and soft-tissue procedures in a different extremity region; clinically analogous to 01712 for tendon procedures but focused on lower extremity. |