CPT CODES

CPT Code 01850

CPT code 01850 is used to describe anesthesia services for surgical procedures on veins in the lower arm.

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 01850

CPT code 01850 is used to describe anesthesia services provided for surgical procedures on the veins of the lower arm. This code is specifically utilized by anesthesiologists or certified registered nurse anesthetists (CRNAs) to document and bill for the administration of anesthesia during surgeries involving the veins in the lower arm region. The use of this code ensures that the anesthesia services are accurately recorded and reimbursed as part of the overall surgical procedure.

Does CPT 01850 Need a Modifier?

For CPT code 01850, which pertains to anesthesia for lower arm vein surgery, the following modifiers may be applicable:

1. Modifier 22 (Increased Procedural Services): Use this modifier if the anesthesia service required significantly more effort than typically required for the procedure due to unusual factors such as patient condition or complexity.

2. Modifier 23 (Unusual Anesthesia): This modifier is applicable when a procedure that usually requires no anesthesia or local anesthesia must be performed under general anesthesia due to unusual circumstances.

3. Modifier 47 (Anesthesia by Surgeon): If the surgeon administers the anesthesia, this modifier should be appended to the surgical procedure code, not the anesthesia code.

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

5. Modifier 76 (Repeat Procedure by Same Physician): This modifier is used when the same procedure is repeated by the same physician or healthcare provider.

6. Modifier 77 (Repeat Procedure by Another Physician): Use this modifier when the procedure is repeated by a different physician or healthcare provider.

7. Modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period): This modifier is used when a patient returns to the operating room for a related procedure during the postoperative period.

8. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Use this modifier when a procedure performed during the postoperative period is unrelated to the original procedure.

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

10. Modifier QK (Medical Direction of Two, Three, or Four Concurrent Anesthesia Procedures Involving Qualified Individuals): Use this modifier when an anesthesiologist is directing multiple anesthesia procedures.

11. Modifier QS (Monitored Anesthesia Care Service): This modifier is used to indicate that monitored anesthesia care was provided.

12. Modifier QX (CRNA Service with Medical Direction by a Physician): Use this modifier when a Certified Registered Nurse Anesthetist (CRNA) provides anesthesia services under the medical direction of a physician.

13. Modifier QY (Medical Direction of One CRNA by an Anesthesiologist): This modifier is used when an anesthesiologist provides medical direction for one CRNA.

14. Modifier QZ (CRNA Service without Medical Direction by a Physician): Use this modifier when a CRNA provides anesthesia services without the medical direction of a physician.

These modifiers help provide additional information about the anesthesia service, ensuring accurate billing and reimbursement. It is important to select the appropriate modifier based on the specific circumstances of the procedure.

CPT Code 01850 Medicare Reimbursement

CPT code 01850 is associated with anesthesia services for lower arm vein surgery. To determine if this specific CPT code is reimbursed by Medicare, one must refer to the Medicare Physician Fee Schedule (MPFS). The MPFS is a comprehensive listing of fees used by Medicare to reimburse physicians and other healthcare providers for services rendered.

Reimbursement for CPT code 01850 under Medicare depends on several factors, including whether the service is covered under the MPFS and the specific policies of the Medicare Administrative Contractor (MAC) that processes claims in your region. MACs are responsible for interpreting national Medicare policies and may have local coverage determinations (LCDs) that affect reimbursement.

To verify if CPT code 01850 is reimbursed by Medicare, healthcare providers should:

1. Check the MPFS to see if the code is listed and what the associated reimbursement rate is.

2. Consult the local MAC's guidelines and LCDs for any specific coverage criteria or documentation requirements that might affect reimbursement.

Ultimately, while the MPFS provides a baseline for reimbursement, the MAC's policies will determine the final eligibility and payment for CPT code 01850.

Are You Being Underpaid for 01850 CPT Code?

Discover the power of MD Clarity's RevFind software to ensure you're receiving every dollar you're owed. With the ability to read your contracts and detect underpayments down to the CPT code level, including specific codes like 01850, RevFind provides unparalleled accuracy in identifying discrepancies by individual payer. Schedule a demo today to see how RevFind can enhance your revenue cycle management and optimize your financial outcomes.

Get paid in full by bringing clarity to your revenue cycle

Full Page Background