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2025 CPT code 00836

Anesthesia services for hernia repair in the lower abdomen for infants less than 37 weeks gestational age at birth and less than 50 weeks gestational age at the time of surgery.

Follow standard anesthesia coding guidelines and ensure proper documentation supports the complexity of the case and the time spent.

Modifiers may apply depending on the specific circumstances of the anesthesia service.Consult payer-specific guidelines for applicable modifiers (e.g., AA, AD, QK, QY, GC, QX, QZ, G8, G9, QS, 23, 53, 59, 76, 77, P1-P6).

Surgical repair of the hernia is medically necessary to prevent complications such as bowel obstruction or incarceration. Anesthesia is medically necessary to provide pain relief, maintain hemodynamic stability, and allow for safe surgical intervention.

The anesthesia provider is responsible for the pre-operative evaluation, induction and maintenance of anesthesia, monitoring the patient's vital signs and administering medications, and overseeing the post-operative transfer to post-anesthesia care.

IMPORTANT:Do not report 00836 in conjunction with 99100 (Qualifying Circumstances for Anesthesia).

In simple words: This code covers the doctor's work giving anesthesia (medicine to make the patient sleep) for a baby's hernia surgery in the lower belly. The baby must be born prematurely (before 37 weeks) and be under 50 weeks old when the surgery occurs. The doctor also checks on the baby before and after the surgery.

This CPT code encompasses anesthesia services rendered during the repair of a hernia located in the lower abdomen for an infant patient.The infant must be less than 37 weeks gestational age at birth and less than 50 weeks gestational age at the time of the surgery. The anesthesia provider's responsibilities include pre-operative evaluation, induction of anesthesia, monitoring during the procedure, administration of medications and fluids as needed, standard monitoring (ECG, temperature, blood pressure, oximetry, capnography), and post-operative care oversight for transfer to post-anesthesia care.Unusual monitoring (Swan-Ganz catheters, intra-arterial lines, or central venous lines) is not included and should be billed separately with appropriate documentation.The code applies to procedures not specified by any other anesthesia code.

Example 1: A 34-week-old premature infant undergoes an inguinal hernia repair. The anesthesiologist administers anesthesia, monitors the infant throughout the procedure, and manages any complications., A 48-week-old infant with a umbilical hernia requires surgical repair. The CRNA provides anesthesia, including pre-operative evaluation, monitoring, and post-operative care, according to established protocols., A 32-week-old preterm infant requires emergency hernia repair due to complications.The anesthesiologist manages the emergency situation, including airway management and fluid resuscitation, in addition to providing anesthesia.

Complete anesthesia record including pre-operative assessment, type and amount of anesthesia agents used, monitoring parameters (ECG, SpO2, blood pressure, etc.), intraoperative events, post-operative assessment, and transfer to post-anesthesia care.Documentation of gestational age at birth and age at time of surgery is required.

** This code should only be used when no other more specific anesthesia code applies to the hernia repair.Always refer to the most current CPT coding guidelines for accurate billing.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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