CPT CODES

CPT Code 01202

CPT code 01202 is used for anesthesia services during a hip arthroscopy procedure, helping standardize and streamline healthcare documentation.

Accelerate your revenue cycle

Boost patient experience and your bottom line by automating patient cost estimates, payer underpayment detection, and contract optimization in one place.

Get a Demo

What is CPT Code 01202

CPT code 01202 is used to describe the anesthesia services provided during an arthroscopic procedure on the hip. Arthroscopy is a minimally invasive surgical technique used to diagnose and treat problems inside a joint. In this context, the code specifically pertains to the administration of anesthesia to ensure the patient remains comfortable and pain-free while the surgeon performs the hip arthroscopy. This code is crucial for billing and documentation purposes, as it helps healthcare providers accurately report the anesthesia services rendered during such procedures.

Does CPT 01202 Need a Modifier?

When billing for CPT code 01202, which pertains to anesthesia for arthroscopy of the hip, certain modifiers may be necessary to provide additional information about the service rendered. Here is a list of potential modifiers that could be used with this code, along with the reasons for their use:

1. Modifier 22 - Increased Procedural Services: Use this modifier if the anesthesia service was significantly more complex or required more time than usual due to unusual circumstances.

2. Modifier 23 - Unusual Anesthesia: This modifier is applicable when a procedure that typically does not require anesthesia or sedation requires it due to unusual circumstances.

3. Modifier 47 - Anesthesia by Surgeon: If the surgeon personally administers the anesthesia, this modifier should be appended to indicate that the anesthesia was not provided by an anesthesiologist or CRNA.

4. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that the anesthesia service was distinct or independent from other services performed on the same day.

5. Modifier AA - Anesthesia Services Performed Personally by Anesthesiologist: This modifier is used when the anesthesiologist personally performs the anesthesia service.

6. Modifier QK - Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures: Use this modifier when an anesthesiologist is directing multiple anesthesia procedures simultaneously.

7. Modifier QX - CRNA Service with Medical Direction by a Physician: This modifier is used when a Certified Registered Nurse Anesthetist (CRNA) provides the anesthesia service under the medical direction of a physician.

8. Modifier QY - Medical Direction of One CRNA by an Anesthesiologist: Use this modifier when an anesthesiologist provides medical direction for a single CRNA.

9. Modifier QZ - CRNA Service without Medical Direction by a Physician: This modifier is applicable when a CRNA provides anesthesia services without the medical direction of a physician.

10. Modifier P1-P6 - Physical Status Modifiers: These modifiers are used to indicate the patient's physical status and range from P1 (a normal healthy patient) to P6 (a declared brain-dead patient whose organs are being removed for donor purposes).

Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement for anesthesia services related to hip arthroscopy.

CPT Code 01202 Medicare Reimbursement

The CPT code 01202, which is associated with anesthesia services for arthroscopy of the hip, is reimbursed by Medicare. To determine the reimbursement specifics, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS), which outlines the payment rates for services covered under Medicare Part B.

Additionally, it is important to consult with the local Medicare Administrative Contractor (MAC) as they are responsible for processing claims and can provide guidance on any regional variations or specific billing requirements that may affect reimbursement for CPT code 01202.

Are You Being Underpaid for 01202 CPT Code?

Discover the power of MD Clarity's RevFind software to ensure you're receiving the full reimbursement you deserve. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 01202, RevFind provides unparalleled accuracy and insight. Schedule a demo today to see how RevFind can help you identify discrepancies by individual payer and optimize your revenue cycle management.

Get paid in full by bringing clarity to your revenue cycle

Full Page Background