Summary & Overview
CPT 01652: Anesthesia for Axillary-Brachial Aneurysm Procedures
CPT code 01652 designates anesthesia services for surgical procedures addressing axillary-brachial aneurysms. This code is significant for providers and payers nationwide, as it ensures accurate billing and reimbursement for complex vascular anesthesia care. The code is most commonly utilized in outpatient hospital settings, reflecting the trend toward ambulatory surgical management of vascular conditions.
Major national payers, including Aetna, Blue Cross Blue Shield, Cigna Health, and UnitedHealthcare, recognize and reimburse for CPT code 01652. The publication provides a comprehensive overview of payer coverage, typical clinical scenarios, and relevant policy updates. Readers will gain insight into the clinical context of axillary-brachial aneurysm procedures, common modifiers used in billing, and associated provider taxonomies. Additionally, the summary highlights related CPT codes and ICD-10 diagnoses that may be encountered in conjunction with this anesthesia service.
This article serves as a resource for understanding the scope of anesthesia billing for axillary-brachial aneurysm procedures, offering benchmarks and policy perspectives relevant to hospitals, anesthesiologists, and certified registered nurse anesthetists. The information is organized to support compliance and clarity in medical billing and coding practices.
CPT Code Overview
CPT code 01652 is used to report anesthesia services for procedures involving an axillary-brachial aneurysm. This code is classified under anesthesia and is typically performed in an outpatient hospital setting (Place of Service 22). The procedure requires specialized anesthesia care to ensure patient safety and comfort during surgical intervention on the axillary-brachial arteries.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with an axillary-brachial artery aneurysm requiring surgical intervention. The procedure involves anesthesia services for the repair or management of the aneurysm in the axillary-brachial region. The clinical workflow includes preoperative assessment, administration of anesthesia by an anesthesiologist or certified registered nurse anesthetist, intraoperative monitoring, and postoperative care. The patient may have comorbid conditions such as pain in the lower extremities or recent fractures, as indicated by associated ICD-10 diagnoses.
Coding Specifications
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Modifiers:
QS: Monitored anesthesia care service. Used when anesthesia is provided with continuous monitoring but not general anesthesia.QX: CRNA service with medical direction by a physician. Used when a certified registered nurse anesthetist provides anesthesia under physician supervision.
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Provider Taxonomies:
Taxonomy Code Specialty Name 207L00000XAnesthesiology 367500000XCertified Registered Nurse Anesthetist 207LA0401XPain Medicine (Anesthesiology)
These taxonomies represent providers qualified to deliver anesthesia services for axillary-brachial aneurysm procedures.
Related Diagnoses
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S82.101A- Unspecified fracture of right tibia, initial encounter for closed fracture- Relevant for patients presenting with trauma or injury, which may necessitate vascular assessment or intervention.
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M25.571- Pain in right ankle and joints of right foot- Indicates musculoskeletal pain, possibly related to vascular compromise or injury.
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M79.671- Pain in right foot- Represents localized pain, which may be associated with vascular or orthopedic conditions.
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S93.401A- Sprain of unspecified ligament of right ankle, initial encounter- Suggests recent injury, which may be part of the clinical scenario leading to vascular evaluation.
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M25.572- Pain in left ankle and joints of left foot- Indicates pain in the contralateral limb, relevant for comprehensive assessment in vascular cases.
Each diagnosis code reflects conditions that may coexist or contribute to the clinical presentation requiring anesthesia for axillary-brachial aneurysm repair.
Related CPT Codes
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01650- ANESTHESIA ARTERIES SHOULDER & AXILLA NOS- Used for anesthesia services involving arteries of the shoulder and axilla not otherwise specified. May be an alternative to
01652when the procedure is less specific.
- Used for anesthesia services involving arteries of the shoulder and axilla not otherwise specified. May be an alternative to
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01654- ANES ARTERIES SHOULDER & AXILLA BYPASS GRAFT- Used for anesthesia during bypass graft procedures in the shoulder and axilla arteries. Related to
01652when a bypass graft is performed instead of aneurysm repair.
- Used for anesthesia during bypass graft procedures in the shoulder and axilla arteries. Related to
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01656- ANESTHESIA AXILLARY-FEMORAL BYPASS GRAFT- Used for anesthesia services during axillary-femoral bypass graft procedures. May be used in cases where the surgical approach extends beyond the axillary-brachial region.
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01670- Anesthesia for all procedures on veins of shoulder and axilla- Used for anesthesia services involving venous procedures in the shoulder and axilla. Related as an alternative when the procedure involves veins rather than arteries.
These codes are commonly used as alternatives or in conjunction with 01652 depending on the specific vascular procedure performed.
National Reimbursement Benchmarks
For CPT code 01652, the national mean rate for BUCA (average commercial) is $220.81, which is substantially higher than the UnitedHealth Group mean rate of $65.65. Among commercial payers, Cigna and Blue Cross Blue Shield have the highest mean rates at $553.65 and $516.82, respectively, while Aetna and BUCA are lower.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies significantly across payers. UnitedHealth Group shows the tightest range at $25.10, indicating less variability in rates. In contrast, Cigna has the widest dispersion at $775.67, followed by Aetna at $523.67, reflecting greater variability in contracted rates. Blue Cross Blue Shield and BUCA also exhibit substantial ranges, at $280.83 and $315.17, respectively.
The table and chart below present the full breakdown of national benchmarks for CPT code 01652 by payer.
State Benchmarks
State: AK1 / 50
Alaska Benchmarks
Alaska displays a wide rate spread for CPT code 01652, particularly among Blue Cross Blue Shield, where the difference between the 75th and 25th percentiles is $208.25 ($726.25 minus $518.00). BUCA also shows a substantial spread of $325.00 ($547.00 minus $222.00), while Aetna, Cigna, and UnitedHealth Group have much narrower spreads, all under $21.00. This indicates significant variability in reimbursement depending on payer.
Compared to national averages, Alaska's mean rates for Blue Cross Blue Shield and BUCA are considerably higher, while Aetna and Cigna are below their national means. UnitedHealth Group's mean rate in Alaska is slightly above its national average. The table and chart below present the full breakdown of payer-specific rates in Alaska.
Key Insights for Alaska
- Blue Cross Blue Shield is the highest paying payer in Alaska for CPT 01652, with a mean rate of $630.97.
- UnitedHealth Group offers the lowest mean rate at $74.78, significantly below both the state and national averages.
- Alaska's mean rates for most payers, especially Blue Cross Blue Shield and BUCA, are notably higher than their respective national averages, indicating a premium reimbursement environment.
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