How To Use CPT Code 00474

cpt 00474 describes anesthesia services for a patient undergoing a partial rib resection, specifically for radical procedures such as pectus excavatum. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 00474.

1. What is cpt 00474?

cpt 00474 is a code used to describe anesthesia services provided to a patient undergoing a partial rib resection, particularly for radical procedures like pectus excavatum. This code is used when an anesthesia provider administers anesthesia to the patient during the surgical removal of a portion of the ribs.

2. Official Description

The official description of cpt 00474 is: ‘Anesthesia for partial rib resection; radical procedures (eg, pectus excavatum).’ This code specifically applies to the administration of anesthesia during a partial rib resection for radical procedures.

3. Procedure

The anesthesia provider begins by performing a pre-operative evaluation of the patient. This evaluation helps assess the patient’s overall health and determine the appropriate anesthesia plan for the procedure. During the partial rib resection, the anesthesia provider induces and maintains anesthesia, ensuring the patient remains unconscious and pain-free throughout the surgery. They closely monitor the patient’s vital signs, administer medications as needed, and adjust the anesthesia level accordingly. After the procedure, the anesthesia provider oversees the patient’s transfer to the post-anesthesia care unit.

4. Qualifying circumstances

cpt 00474 is used when the patient requires anesthesia services for a partial rib resection, specifically for radical procedures like pectus excavatum. The anesthesia provider must be qualified and authorized to administer anesthesia, such as an anesthesiologist, doctor of medicine or osteopathy, dentist, oral surgeon, podiatrist, certified registered nurse anesthetist (CRNA), or anesthesiologist assistant (AA). The patient’s condition must necessitate the use of anesthesia during the surgical removal of a portion of the ribs.

5. When to use cpt code 00474

cpt 00474 should be used when an anesthesia provider administers anesthesia during a partial rib resection for radical procedures, such as pectus excavatum. It is important to accurately document the specific procedure and the need for anesthesia services in the medical record to support the use of this code.

6. Documentation requirements

To support a claim for cpt 00474, the anesthesia provider must document the following information:

• Patient’s pre-operative evaluation
• Type and amount of medications administered
• Monitoring methods used during anesthesia
• Patient’s response to anesthesia
• Start and stop times of anesthesia care
• Details of the partial rib resection procedure
• Transfer of the patient to the post-anesthesia care unit

7. Billing guidelines

When billing for cpt 00474, ensure that the anesthesia provider administering the anesthesia is qualified and authorized to do so. Follow the specific billing guidelines provided by the payer, including any required modifiers or additional documentation. It is important to accurately report the anesthesia time and any additional procedures or services provided during the same encounter.

8. Historical information

cpt 00474 was added to the Current Procedural Terminology system on January 1, 1990. It has undergone changes in its status as an inpatient-only (IPO) procedure for Medicare reimbursement. As of 2022, it is once again listed as an inpatient-only procedure for Medicare.

9. Similar codes to cpt 00474

Similar codes to cpt 00474 within the range of anesthesia for procedures on the thorax (chest wall and shoulder girdle) include:

• cpt 00400: Anesthesia for procedures on the thorax (chest wall and shoulder girdle); not otherwise specified
• cpt 00402: Anesthesia for procedures on the thorax (chest wall and shoulder girdle); biopsy of soft tissue
• cpt 00410: Anesthesia for procedures on the thorax (chest wall and shoulder girdle); repair of pectus excavatum or carinatum
• cpt 00420: Anesthesia for procedures on the thorax (chest wall and shoulder girdle); repair of pectus excavatum or carinatum with implantation of prosthesis
• cpt 00430: Anesthesia for procedures on the thorax (chest wall and shoulder girdle); repair of pectus excavatum or carinatum with implantation of prosthesis, with or without sternotomy

9. Examples

1. An anesthesiologist providing anesthesia services during a partial rib resection for a patient with pectus excavatum.
2. A certified registered nurse anesthetist (CRNA) administering anesthesia during a radical procedure involving the removal of a portion of the ribs.
3. An oral surgeon providing anesthesia for a patient undergoing a partial rib resection for a radical procedure.
4. A dentist administering anesthesia during a surgical intervention for pectus excavatum.
5. An anesthesiologist assistant (AA) assisting in the administration of anesthesia during a partial rib resection for a radical procedure.
6. A doctor of medicine or osteopathy providing anesthesia services for a patient undergoing a rib resection for pectus excavatum.
7. An anesthesiologist overseeing the anesthesia care during a radical procedure involving the removal of a portion of the ribs.
8. A podiatrist administering anesthesia during a partial rib resection for a patient with pectus excavatum.
9. A CRNA monitoring the patient’s anesthesia during a radical procedure on the ribs.
10. An anesthesiologist assistant (AA) assisting in the induction and maintenance of anesthesia during a partial rib resection for a radical procedure.