Summary & Overview
CPT 01840: Anesthesia for Forearm, Wrist, and Hand Arterial Procedures
CPT code 01840 designates anesthesia services for surgical procedures on arteries of the forearm, wrist, and hand (for example, radial, ulnar, and digital arteries). This anesthetic category covers services associated with vascular procedures of the distal upper extremity and is used when no other anesthesia code more specifically applies. Nationally, accurate reporting of this code supports appropriate anesthesia billing and clinical documentation for peripheral arterial surgery.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical setting for use of the code, common modifiers and payer considerations, and expected sites of service. The publication summarizes benchmark topics such as typical utilization patterns, coding guidance context, and payer coverage perspectives relevant to anesthesia for forearm, wrist, and hand arterial procedures. The summary also highlights where input was not provided: associated taxonomies, ICD-10 diagnoses, and related codes are not available in the input.
This resource is aimed at billing professionals, anesthesia providers, and policy analysts seeking a clear national-level description of CPT code 01840, its clinical context, and the payer landscape for anesthesia services tied to distal upper-extremity arterial surgery.
Billing Code Overview
CPT code 01840 describes anesthesia services provided for procedures on the arteries of the forearm, wrist, and hand, including the radial, ulnar, and digital arteries. This code is used when the anesthesia service is specific to arterial surgery of the forearm, wrist, or hand and when no other anesthesia code more precisely describes the procedure.
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Service type: Anesthesia services for arterial procedures of the forearm, wrist, and hand
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Typical site of service: Operating room or procedure suite where vascular surgery on the forearm, wrist, or hand is performed
Clinical & Coding Specifications
Clinical Context
A 58-year-old male presents to the ambulatory surgical center with a nonhealing dorsal hand laceration after a saw injury that transected a superficial branch of the radial artery. Preoperative evaluation by the hand surgery team documents an isolated arterial injury to the forearm/wrist/hand requiring microsurgical repair under general or regional anesthesia. The anesthesia team performs perioperative anesthesia services for arterial repair of the radial artery in the wrist, including induction, airway management, intraoperative monitoring, vascular access as needed, and perioperative analgesia. The procedure is performed in an outpatient operating room; postoperative recovery includes monitoring in the PACU with regional block assessments and multimodal pain control prior to discharge or admission.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
AA | Anesthesia services performed personally by anesthesiologist | Use when the anesthesiologist personally performs the anesthesia for the arterial repair procedure. |
AD | Medical supervision by anesthesiologist; more than four concurrent anesthesia procedures | Use when the anesthesiologist medically supervises multiple concurrent anesthesia procedures. |
AS | Physician service for anesthesia furnished in part-time hospital setting | Use when the supervising anesthesiologist provides services in an ambulatory surgery center setting per applicable payer rules. |
QK | Medical direction of two, three, or four qualified anesthesia personnel | Use when the anesthesiologist medically directs multiple CRNAs during the arterial repair case. |
QX | CRNA service: CRNA with medical direction by a physician | Use when a CRNA performs the anesthesia under the direction of a physician for the hand arterial repair. |
QS | Monitored anesthesia care (MAC) service | Use if the service provided qualifies as monitored anesthesia care rather than general anesthesia. |
23 | Unusual anesthesia for part of a procedure | Use when unusually difficult anesthesia conditions occur related to the arterial repair (rare) that are unrelated to the surgical complexity. |
62 | Two surgeons — concurrent procedure by two surgeons | Use when a separate surgeon assists or performs a concurrent procedure on the ipsilateral limb during the same operative session. |
78 | Unplanned return to OR following initial procedure for a related procedure during global period | Use when the patient requires an unplanned return to the operating room for a complication related to the arterial repair, necessitating additional anesthesia services. |
50 | Bilateral procedure | Use when identical arterial procedures are performed bilaterally in the same operative session (rare for hand arteries). |
52 | Reduced services | Use when the anesthesia service is reduced or incomplete compared with the full procedure. |
53 | Discontinued procedure | Use when the anesthesia service is terminated due to patient-related or intraoperative conditions before completion of the planned arterial repair. |
55 | Postoperative management only | Use when the billing is only for postoperative anesthesia management separate from intraoperative services. |
56 | Preoperative assessment only | Use when billing is for preoperative anesthesia evaluation only and intraoperative services are not provided. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2084P0800X | Anesthesiology | Primary providers of anesthesia services for forearm/wrist/hand arterial procedures. |
| 207L00000X | Surgery - Hand | Hand surgeons (orthopedic/plastic) who perform arterial repairs and coordinate anesthesia. |
| 207W00000X | Surgery - Plastic | Plastic surgeons who perform microsurgical arterial repair on hand and wrist. |
| 207X00000X | Surgery - Orthopedic | Orthopedic surgeons with hand specialty performing arterial repairs. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S54.211A | Laceration of radial artery of right forearm, initial encounter | Direct traumatic injury to a forearm artery necessitating repair under anesthesia. |
S54.212A | Laceration of ulnar artery of right forearm, initial encounter | Ulnar artery laceration leading to operative arterial repair. |
S64.311A | Laceration of superficial palmar arch of right hand, initial encounter | Vascular injury in the hand requiring exploration and repair. |
I77.3 | Aneurysm of artery of upper extremity | Nontraumatic arterial pathology occasionally requiring operative intervention and anesthesia. |
I83.819 | Varicose veins of unspecified lower extremity with other complications | Data not applicable to this procedure; included for completeness only. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
36415 | Collection of venous blood by venipuncture | Preoperative labs, type and crossmatch or coagulation testing prior to arterial repair and anesthesia. |
99100 | Anesthesia for patient of extreme age, younger than 1 year and older than 70 (add-on) | May be appended when applicable for very elderly patients requiring additional anesthesia time/complexity for arterial repair. |
64450 | Injection, anesthetic agent; Stellate ganglion or thoracic sympathectomy | Regional block codes such as peripheral nerve or sympathetic blocks may be used adjunctively for hand/forearm analgesia (note: specific block codes depend on technique). |
64727 | Neuroplasty and/or transposition; median nerve at carpal tunnel | Related hand surgical procedures; may be performed concurrently or in staged fashion with arterial repair when indicated. |
29848 | Arthroscopy, wrist, surgical; debridement, limited | Other wrist procedures that may be performed in the same operative session and require anesthesia coordination. |