Question Orthopedic joint replacement and epidural anesthesia

starwynde

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My MTF surgeons have started using epidural anesthesia in lieu of general anesthesia for qualified hip and knee replacement candidates. I have confirmed with the anesthesia providers this is not a nerve block for pain in addition the general, as that was my first thought. As I can't use the 01967 Epidural code as it is obstetrics specifics, my question is: What is the appropriate code to use for this anesthesia? I really appreciate any insight.
 

LisaAlonso23

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My MTF surgeons have started using epidural anesthesia in lieu of general anesthesia for qualified hip and knee replacement candidates. I have confirmed with the anesthesia providers this is not a nerve block for pain in addition the general, as that was my first thought. As I can't use the 01967 Epidural code as it is obstetrics specifics, my question is: What is the appropriate code to use for this anesthesia? I really appreciate any insight.

In the event the epidural is the primary anesthetic, the coding process doesn't change.

Per the 2021 Relative Value Guide, the 01967 descriptor is Neuraxial labor analgesia/anesthesia for planned vaginal delivery.

That said, 01967 would not be the appropriate code in the scenario you're describing.

In cases of hip and/or knee replacement, you would code the procedure and crosswalk it to the appropriate ASA code.

Total hip replacement CPT = 27130, ASA = 01214

Total knee replacement CPT = 27447, ASA = 01402
 
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starwynde

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Thank you! Nobody at my facility has been able to answer this question. I knew I couldn't use the 01967, but the neuraxial route with light sedation (sometimes oral, sometimes IV) was throwing me for a loop. This makes it easy again.
 
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