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    OpenPayerBilling CodesAnesthesia for Procedures on the Forearm, Wrist, and HandCPT cpt-01860-forearm-wrist-hand-cast-anesthesia
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    CPT 01860: Anesthesia for Forearm, Wrist, or Hand Cast Application or Revision

    CPT code 01860 describes anesthesia services provided for patients undergoing forearm, wrist, or hand cast application or revision; the service is anesthesia for procedures involving cast placement or reapplication to meet clinical needs, typically delivered as monitored anesthesia care or regional/local anesthesia in an ambulatory surgery center, emergency department, or clinic/procedure room depending on patient condition and setting.

    For related coverage guidance, see recent payer policy updates: Dental Anesthesia Services, Anesthesia Services for Interventional Pain Management Procedures in an Adult, General Anesthesia and Conscious Sedation Services.

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    Clinical & Coding Specifications

    Clinical Context

    A typical patient is an adult or pediatric patient who presents to an ambulatory surgical center, emergency department, or orthopedic clinic for application or revision of a forearm, wrist, or hand cast following a closed distal radius, ulna, metacarpal, or phalangeal fracture, or for immobilization after soft-tissue injury. The patient may arrive after initial closed reduction in the emergency department or clinic, or return for cast revision due to poor fit, neurovascular compromise, excessive swelling, pressure areas, or planned conversion from a temporary splint to a definitive cast. The clinical workflow includes pre-procedure evaluation by the anesthesia team (medical history, ASA classification, airway assessment), informed consent for anesthesia, placement of appropriate anesthesia (monitored anesthesia care or regional block such as axillary or supraclavicular block or local infiltration with sedation), intra-procedural monitoring, participation during cast application or molding by the orthopedic provider, and post-anesthesia recovery with documentation of anesthetic type, drugs, and patient response. Typical sites of service are ambulatory surgical centers, hospital outpatient departments, emergency departments, and inpatient wards when the patient is admitted for associated injuries or comorbidities.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    01860Anesthesia for procedures involving forearm, wrist, or hand cast application or revisionPrimary anesthesia code describing services for cast application or revision of the forearm, wrist, or hand.
    20600Arthrocentesis, aspiration and/or injection, small joint or bursa (eg, finger, toe)May be performed before casting to reduce swelling or inject anesthetic in small joints prior to casting.
    25600Closed treatment of distal radial fracture (e.g., Colles or Smith type) without manipulationRelated orthopedic management that may be accompanied by anesthesia for cast application.
    25605Closed treatment of distal radial fracture; with manipulationWhen reduction with manipulation is required prior to casting, anesthesia is commonly provided.
    29125Application of cast; forearm and elbowCast application codes for the actual casting procedure performed by orthopedics in conjunction with anesthesia services.
    29075Application of short arm cast (below elbow to hand)Specific cast application code commonly billed by orthopedics when anesthesia is provided for comfort during molding.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    23Modifier -23 (Unusual Anesthesia) is used on anesthesia service CPT codes when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia…- Use modifier -23 only on anesthesia CPT codes (00100–01999) when a procedure that normally requires no anesthesia or only local anesthesia must be performed under general anesthesia because of…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    54Modifier ‑54 (“Surgical care only”) is appended to a CPT surgical procedure when the reporting surgeon performs the intraoperative (surgical) component but does not furnish the preoperative and/or…- Use modifier -54 when the reporting surgeon provided only the intraoperative (surgical) component of a procedure and preoperative and/or postoperative management has been or will be provided by…
    55Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…
    56Modifier ‑56 indicates the reporting provider furnished only the preoperative management for a surgical procedure and did not perform the intraoperative or postoperative care. It is used in…- Use Modifier -56 when a provider performs only the preoperative management in a split‑care situation (one physician manages preop care while a different physician performs the intraoperative…
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…

    Related Provider Taxonomies

    8 rows

    Taxonomy Code
    2084N0400X
    207L00000X
    207RG0100X
    207SG0207X
    364SA2200X
    207W00000X
    363AS0400X
    103TA0400X

    Related ICD-10-CM Codes

    25 rows

    ICD-10-CM CodeDescription
    G56.01Carpal tunnel syndrome, right upper limb
    G56.02Carpal tunnel syndrome, left upper limb
    M19.071Primary osteoarthritis, right ankle and foot
    M19.072Primary osteoarthritis, left ankle and foot
    M20.10Hallux valgus (acquired), unspecified foot
    M20.11Hallux valgus (acquired), right foot
    M25.541Pain in joints of right hand
    M25.542Pain in joints of left hand
    M79.642Pain in left hand
    M79.643Pain in unspecified hand

    Showing 1–10 of 25

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    10 rows

    PolicyPayerEffective Date
    Dental Anesthesia ServicesProvidence Health Plan2026-10-01
    Anesthesia Services for Interventional Pain Management Procedures in an AdultCigna2026-09-15
    General Anesthesia and Conscious Sedation ServicesUnitedHealthcare2026-09-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21

    Related Codes

    CPT-01810-ANESTHESIA-FOREARM-WRIST-HAND-PROCEDURES

    CPT 01810: Anesthesia for Forearm, Wrist, and Hand Procedures

    CPT-01820-ANESTHESIA-CLOSED-RADIUS-ULNA-WRIST-HAND-PROCEDURE

    CPT 01820: Anesthesia for Closed Procedure on Radius/Ulna/Wrist/Hand

    CPT-01829-WRIST-ARTHROSCOPY-ANESTHESIA-DIAGNOSTIC

    CPT 01829: Anesthesia for Diagnostic Arthroscopy of the Wrist

    CPT-01830-ANESTHESIA-DISTAL-RADIUS-WRIST-HAND-PROCEDURES

    CPT 01830: Anesthesia for Distal Radius/Ulna, Wrist, or Hand Procedures

    CPT-01832-TOTAL-WRIST-REPLACEMENT-ANESTHESIA

    CPT 01832: Anesthesia for Total Wrist Replacement

    CPT-01840-FOREARM-WRIST-HAND-ARTERIAL-ANESTHESIA

    CPT 01840: Anesthesia for Forearm, Wrist, and Hand Arterial Procedures

    CPT-01842-UPPER-EXTREMITY-ARTERIAL-EMBOLECTOMY-ANESTHESIA

    CPT 01842: Anesthesia for Forearm/Wrist/Hand Arterial Embolectomy

    CPT-01844-VASCULAR-SHUNT-ANESTHESIA-SERVICES

    CPT 01844: Anesthesia for Vascular Shunt or Shunt Revision

    CPT-01850-ANESTHESIA-VEINS-FOREARM-WRIST-HAND

    CPT 01850: Anesthesia for Vein Procedures of Forearm, Wrist, Hand

    CPT-01852-ANESTHESIA-FOR-PHLEBORRHAPHY-FOREARM-WRIST-HAND

    CPT 01852: Anesthesia for Phleborrhaphy of Forearm, Wrist, and Hand

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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