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BETA v.3.0

2025 CPT code 01214

Anesthesia for open procedures involving hip joint; total hip arthroplasty.

Use appropriate modifiers to denote specific circumstances, such as unusual anesthesia (23), patient physical status (P1-P6), or the involvement of a CRNA or anesthesiologist assistant.

Modifiers are applicable. Common modifiers include physical status modifiers (P1-P6), qualifying circumstances modifiers (e.g., 99100 for extreme age), and modifiers indicating the type of anesthesia service provided (e.g., AA, AD, QK, QS).

Medical necessity must be substantiated by documentation confirming a diagnosis requiring total hip arthroplasty, along with justification for the chosen anesthetic technique.

The anesthesiologist is responsible for the patient's well-being before, during, and immediately after the surgery. Duties include pre-operative assessment, inducing and maintaining anesthesia, monitoring vital signs (ECG, temperature, blood pressure, oxygen saturation, and carbon dioxide levels), administering medications and fluids, and managing post-operative pain relief before transferring the patient to post-anesthesia care.

In simple words: This code covers the anesthesia services provided by a medical professional during open hip replacement surgery. The anesthesiologist assesses the patient before and after the procedure, administers medication to keep the patient comfortable during the operation, and closely monitors vital signs. It encompasses the basic monitoring procedures but excludes any specialized monitoring techniques.

This code represents anesthesia services provided for an open total hip arthroplasty, including pre- and post-operative evaluation, intraoperative care, and administration of fluids/blood and standard monitoring.It does not include unusual forms of monitoring such as Swan-Ganz catheters, intraarterial lines, or central venous lines, which should be coded separately.

Example 1: A 70-year-old patient undergoes a total hip arthroplasty due to osteoarthritis. The anesthesiologist administers general anesthesia and monitors the patient throughout the procedure., A 55-year-old patient with a history of heart disease requires a total hip arthroplasty following a fracture. The anesthesiologist opts for spinal anesthesia with sedation, given the patient's cardiac condition., A 30-year-old athlete undergoes revision hip arthroplasty after a failed previous replacement. The anesthesiologist employs a combined spinal-epidural technique for anesthesia and post-operative pain management.

Complete documentation should include patient history and physical, pre-anesthesia assessment, type and amount of anesthesia administered, monitoring techniques employed, patient response to anesthesia, start and end times of anesthesia, and any complications or unusual events.

** Anesthesia time is crucial for reimbursement and is calculated from the start of anesthesia preparation in the operating room to the transfer of post-operative care.Billing for multiple anesthesia procedures during the same encounter requires using the most complex code and combining the total anesthesia time.

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