How To Use CPT Code 00542

cpt 00542 describes the anesthesia services provided for thoracotomy procedures involving the lungs, pleura, diaphragm, and mediastinum, specifically decortication. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of cpt 00542.

1. What is cpt 00542?

cpt 00542 is used to describe the anesthesia services provided for thoracotomy procedures involving the lungs, pleura, diaphragm, and mediastinum, specifically decortication. Anesthesia is administered by a qualified anesthesia provider to ensure the patient’s comfort and safety during the procedure.

2. Official Description

The official description of cpt 00542 is: ‘Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); decortication.’

3. Procedure

1. The anesthesia provider performs a pre-operative evaluation of the patient to assess their overall health and determine the appropriate anesthesia plan.
2. The patient is induced with anesthesia, typically through the administration of intravenous medications.
3. The anesthesia provider monitors the patient’s vital signs, such as blood pressure, heart rate, and oxygen levels, throughout the procedure.
4. The surgeon performs the thoracotomy procedure, which involves opening the chest wall to access the lungs, pleura, diaphragm, and mediastinum.
5. If necessary, the surgeon may use thoracoscopy, a minimally invasive technique that utilizes an endoscope to visualize and perform procedures on the pleura, lungs, and mediastinum.
6. The anesthesia provider administers any additional medications or fluids as needed during the procedure.
7. After the procedure is complete, the anesthesia provider oversees the patient’s transfer to the post-anesthesia care unit (PACU) for recovery.

4. Qualifying circumstances

cpt 00542 is used for patients undergoing thoracotomy procedures involving the lungs, pleura, diaphragm, and mediastinum, specifically decortication. This procedure is typically performed to remove the lining of the lung (decortication) in cases of conditions such as pleural effusion, empyema, or fibrosis. The anesthesia services are provided by a qualified anesthesia provider, such as an anesthesiologist or certified registered nurse anesthetist (CRNA).

5. When to use cpt code 00542

cpt 00542 should be used when anesthesia services are provided for thoracotomy procedures involving the lungs, pleura, diaphragm, and mediastinum, specifically decortication. It is important to ensure that the procedure performed aligns with the description provided by cpt 00542 to accurately report the anesthesia services.

6. Documentation requirements

To support a claim for cpt 00542, the anesthesia provider must document the following information:

• Pre-operative evaluation of the patient
• Details of the anesthesia plan, including the type and amount of medications administered
• Monitoring of the patient’s vital signs throughout the procedure
• Start and stop times of anesthesia care
• Any additional medications or fluids administered during the procedure
• Transfer of the patient to the PACU

7. Billing guidelines

When billing for cpt 00542, ensure that the anesthesia services are provided by a qualified anesthesia provider and that the procedure performed aligns with the description provided by cpt 00542. It is important to follow the specific billing guidelines of the payer, including any required modifiers or additional documentation.

8. Historical information

cpt 00542 was added to the Current Procedural Terminology system on January 1, 1990. It was later added to the Inpatient Only (IPO) list for Medicare reimbursement in 2017.

9. Examples

1. An anesthesiologist providing anesthesia services for a patient undergoing decortication for pleural effusion.
2. A CRNA administering anesthesia to a patient undergoing thoracotomy for the removal of a mediastinal tumor.
3. An anesthesia team providing services for a patient undergoing thoracotomy and thoracoscopy for the treatment of empyema.
4. An anesthesiologist overseeing the anesthesia care for a patient undergoing decortication for lung fibrosis.
5. A CRNA monitoring the anesthesia for a patient undergoing thoracotomy and thoracoscopy for the removal of a pleural mass.
6. An anesthesia provider administering anesthesia to a patient undergoing decortication for chronic pleurisy.
7. A team of anesthesiologists and CRNAs providing anesthesia services for a patient undergoing thoracotomy and thoracoscopy for the treatment of a mediastinal abscess.
8. An anesthesiologist overseeing the anesthesia care for a patient undergoing decortication for pleural thickening.
9. A CRNA administering anesthesia to a patient undergoing thoracotomy for the removal of a diaphragmatic hernia.
10. An anesthesia team providing services for a patient undergoing thoracotomy and thoracoscopy for the treatment of a thymoma.