Summary & Overview
CPT 01842: Anesthesia for Upper-Extremity Arterial Embolectomy
CPT code 01842 represents anesthesia services provided for embolectomy procedures targeting arteries of the forearm, wrist, and hand (including radial, ulnar, and digital arteries). Nationally, this code is used to capture the anesthesia component of care during distal upper-extremity vascular surgery and is relevant for surgical teams, anesthesiology departments, hospital billing offices, and payers managing perioperative vascular care. Accurate coding affects clinical documentation, resource allocation, and payment adjudication for these specialized procedures.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines typical clinical context for 01842, common sites of service, and payer coverage considerations. It also provides benchmarks and billing guidance trends where applicable, summarizes policy updates affecting anesthesia coding in vascular procedures, and situates 01842 within perioperative care workflows.
Readers will learn the clinical scope and intended use of CPT code 01842, how it maps to anesthesia service delivery for upper-extremity embolectomy, what payers commonly cover these services, and where to find policy and reimbursement considerations that influence coding and claims processing. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 01842 describes anesthesia services provided for an embolectomy of arteries in the forearm, wrist, and hand, including procedures on the radial, ulnar, and digital arteries. This code captures the anesthesia component of care during surgical removal of emboli or thrombotic material from these distal upper-extremity arterial segments.
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Service type: Anesthesia services for upper-extremity arterial embolectomy
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Typical site of service: Operating room or procedure suite for hand, wrist, and forearm vascular surgery
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to the emergency department or vascular surgery clinic with acute ischemia of the hand or forearm characterized by sudden pain, pallor, pulselessness, paresthesia, and motor deficits after an embolic event (for example, atrial fibrillation with embolization) or traumatic arterial thrombosis. Initial evaluation includes vascular exam, Doppler ultrasonography, and often CT angiography of the upper extremity to localize the arterial occlusion. When imaging and clinical findings confirm an arterial embolus in the radial, ulnar, or digital arteries with threatened tissue viability, the vascular surgery team schedules an urgent embolectomy under anesthesia.
Perioperative workflow: the anesthesia preoperative assessment documents comorbidities (cardiac arrhythmia, anticoagulation status, pulmonary disease), NPO status, airway assessment, and ASA physical status. Anesthesia choices include monitored anesthesia care with regional block (brachial plexus or forearm block) or general anesthesia with peripheral nerve block adjunct for postoperative analgesia. Intraoperative monitoring follows standard ASA guidelines. The anesthesiologist documents start and stop times for anesthesia care, level of supervision, and any complicating intraoperative events (massive bleeding, conversion to general anesthesia). Postoperative disposition is to the PACU with neurovascular checks and continuation of anticoagulation management coordinated with surgery and cardiology as indicated.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural service | When anesthesia required unusually complex management (e.g., severe hemodynamic instability) that increases work beyond typical for an embolectomy case |
23 | Unusual anesthesia | When anesthesia is administered for an emergency surgical procedure that normally is not performed under anesthesia or when general anesthesia is required for emergency circumstances |
50 | Bilateral procedure | When embolectomies are performed on both upper extremities during the same anesthetic |
52 | Reduced services | When anesthesia time or scope is reduced (partial procedure) compared with the typical complete service |
53 | Discontinued procedure | When anesthesia was initiated but the procedure was terminated prior to completion for patient safety or other documented reason |
62 | Two surgeons | When two surgeons share responsibility (e.g., vascular and hand surgery) and anesthesia documentation reflects concurrent surgical teams |
78 | Return to the operating room (unplanned) | When the patient returns to the OR for a related embolectomy or re-exploration during the global period and a separate anesthesia service is provided |
AA | Anesthesiologist service | When a physician anesthesiologist personally performs the anesthesia service |
AD | Medical supervision by a physician: more than four concurrent anesthesia procedures | When a physician supervises multiple concurrent anesthesia cases exceeding four |
AS | Physician assistant, nurse anesthetist, or CRNA service under direction of anesthesiologist | When an anesthesiology assistant or CRNA provides the service under direction; used per payer policy |
QK | Medical direction of two, three, or four CRNAs/AA by anesthesiologist | When the anesthesiologist medically directs multiple CRNAs/AAs for concurrent embolectomy cases |
QS | Monitored anesthesia care service | When only monitored anesthesia care (MAC) is provided instead of general or regional anesthesia |
QX | CRNA service with medical direction by physician | When a CRNA performs anesthesia under medical direction and payer requires this modifier |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
2084P0800X | Vascular Surgeon | Primary surgical specialty performing arterial embolectomy of forearm/hand |
207RP0000X | Plastic and Reconstructive Surgeon | May perform hand reconstruction or microvascular repair associated with digital ischemia |
207L00000X | Orthopedic Hand Surgeon | Manages hand-specific vascular and soft tissue concerns during emergent procedures |
207K00000X | General Surgeon | May perform embolectomy in centers without dedicated vascular surgeons |
207L00000X | Anesthesiologist (physician) | Provides anesthesia services for upper extremity embolectomy procedures |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
I63.9 | Cerebral infarction, unspecified | Data not applicable to upper extremity embolectomy but sometimes used when systemic embolic events are present |
I74.3 | Embolism and thrombosis of arteries of the upper extremity | Primary indication for embolectomy of radial, ulnar, or digital arteries |
I48.91 | Unspecified atrial fibrillation | Common embolic source leading to upper extremity arterial occlusion requiring embolectomy |
I82.409 | Acute embolism and thrombosis of unspecified deep veins of lower extremity, unspecified | Less directly related; included to reflect thromboembolic disease spectrum |
T79.A1 | Traumatic amputation, initial encounter | Relevant when traumatic arterial injury causes embolism or ischemia to hand necessitating embolectomy |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
34900 | Emergency repair of blood vessel, upper extremity, extra-anatomic; arterial thrombectomy or embolectomy | Surgical code for arterial embolectomy in the upper extremity; often billed by the surgeon in coordination with anesthesia under 01842 |
36215 | Selective catheter placement, arterial system, with diagnostic angiography, radiological supervision and interpretation, upper extremity, unilateral | Preoperative angiographic localization of occlusion that may guide surgical embolectomy |
37220 | Revascularization, endovascular, open or percutaneous, arterial, upper extremity, with or without stent | Endovascular alternatives or adjuncts to open embolectomy; may be performed before or after surgical embolectomy |
64415 | Injection, anesthetic agent; other peripheral nerve or branch (e.g., brachial plexus block) | Regional block used as primary or adjunct anesthetic technique for hand/forearm embolectomy |
99100 | Anesthesia for patient of extreme age, younger than 1 year or older than 70 years, requiring unusual anesthesia management | Supplemental anesthesia code when age-related complexity requires additional management alongside 01842 |