CPT Code 00140
Anesthesia for Procedures on the Eye Billing & Coding Guide
Code Description
CPT code 00140 is used for anesthesia services associated with procedures on the eye that are not otherwise specified by a more specific anesthesia code.
This makes CPT 00140 a broader ophthalmic anesthesia code. Before reporting it, the provider should determine whether the procedure falls under a more specific anesthesia code for services such as lens surgery, corneal transplantation, vitreoretinal surgery, iridectomy, or ophthalmologic examination.
The anesthesia professional may perform a pre-anesthesia evaluation, administer anesthesia or monitored anesthesia care, monitor the patient's physiologic status, manage the airway when necessary, and oversee recovery.
When to Use CPT 00140
Use CPT code 00140 when anesthesia is provided for an eye procedure and there is no more specific anesthesia CPT code that accurately describes the underlying procedure.
Situations may include:
Certain strabismus procedures
Certain orbital procedures involving the eye
Enucleation or evisceration procedures when appropriately classified
Other qualifying ophthalmic procedures not represented by a more specific anesthesia code
The operative report should be reviewed before selecting CPT 00140 because several types of eye surgery have their own specific anesthesia codes.
When NOT to Use CPT Code 00140
Do not report CPT code 00140 when:
A more specific ophthalmic anesthesia code describes the procedure.
The patient undergoes lens surgery appropriately represented by CPT 00142.
The procedure is a corneal transplant appropriately represented by CPT 00144.
The patient undergoes vitreoretinal surgery appropriately represented by CPT 00145.
The procedure involves an iridectomy appropriately represented by CPT 00147.
Documentation does not establish the eye procedure requiring anesthesia.
CPT 00140 should not be treated as the default code for every eye surgery. The underlying procedure should always be reviewed for a more specific anesthesia code first.
Documentation Requirements
Documentation should clearly support the ophthalmic procedure and anesthesia service and include:
Specific eye procedure performed
Eye or anatomical site involved
Medical necessity for the procedure
Pre-anesthesia evaluation
Anesthesia plan
Anesthetic medications administered
Type of anesthesia or monitored anesthesia care provided
Physiologic monitoring
Airway management when applicable
Anesthesia start and stop times
Patient response to anesthesia
Post-anesthesia evaluation and recovery
The operative report should provide enough information to establish why CPT 00140 is appropriate instead of a more specific eye anesthesia code.
The anesthesia record should separately document the anesthesia professional's services, monitoring, time, and patient recovery.
Documentation Checklist
Before submitting CPT code 00140, confirm that the medical record includes:
✓ Eye procedure clearly documented
✓ Medical necessity supported
✓ More specific anesthesia code ruled out
✓ Pre-anesthesia evaluation completed
✓ Anesthesia plan documented
✓ Anesthetic medications recorded
✓ Anesthesia start and stop times recorded
✓ Physiologic monitoring documented
✓ Post-anesthesia recovery documented
Examples
Example 1
A patient undergoes strabismus surgery requiring anesthesia. The procedure does not fall under one of the more specific ophthalmic anesthesia categories. The anesthesia professional documents the pre-anesthesia evaluation, anesthesia administration, monitoring, time, and recovery. CPT code 00140 may be appropriate.
Example 2
A patient undergoes removal of an orbital lesion involving an ophthalmic surgical approach. After reviewing the underlying procedure, no more specific eye anesthesia code applies. The anesthesia provider documents the complete anesthesia service and reports CPT code 00140.
Example 3
A patient undergoes a qualifying eye procedure under monitored anesthesia care. The underlying procedure is not lens surgery, corneal transplantation, vitreoretinal surgery, iridectomy, or another procedure represented by a more specific anesthesia code. CPT code 00140 may be reported when supported by the documentation.
Base Units & Reimbursement
Anesthesia reimbursement for CPT 00140 generally considers the code's base units, documented anesthesia time, and the applicable payer conversion factor.
The basic anesthesia payment methodology generally considers:
Base Units + Time Units + Applicable Additional Units
The resulting units are then applied to the applicable anesthesia conversion factor. Actual reimbursement may vary based on geographic adjustments, provider arrangements, medical direction, qualifying circumstances, and payer-specific policies.
Anesthesia time should be documented accurately according to applicable billing requirements. The surgical procedure time should not automatically be substituted for anesthesia time.
Coding & Billing Tips
Review the actual ophthalmic procedure before selecting CPT 00140.
Use a more specific eye anesthesia code when one accurately describes the procedure.
Do not select CPT 00140 solely because the procedure involves the eye.
Document anesthesia start and stop times accurately.
Match the ICD-10-CM diagnosis to the condition actually being treated.
Document the type of anesthesia or monitored anesthesia care provided.
Apply anesthesia modifiers only when supported by the provider arrangement or circumstances of the service.
Common Billing Mistakes
Using CPT 00140 for every eye procedure
CPT 00140 is not the universal anesthesia code for ophthalmic surgery. Several eye procedures have more specific anesthesia codes that should be used when applicable.
Missing a more specific anesthesia code
Lens surgery, corneal transplantation, vitreoretinal surgery, and certain other ophthalmic procedures have more specific anesthesia codes. Failure to review the underlying procedure can result in incorrect code selection.
Coding from the diagnosis alone
An ophthalmic diagnosis does not determine the anesthesia code by itself. CPT 00140 should be selected based primarily on the procedure requiring anesthesia.
Reporting inaccurate anesthesia time
Incorrect start or stop times can result in inaccurate anesthesia time units and reimbursement.
Incomplete anesthesia documentation
The record should support the anesthesia plan, medications, monitoring, provider involvement, time, and recovery.
Failing to document monitored anesthesia care
When monitored anesthesia care is provided, the anesthesia record should support the level of anesthesia service performed and any applicable modifier requirements.
Common ICD-10-CM Codes
Because CPT 00140 can accompany several different eye procedures, the diagnosis should reflect the specific condition treated rather than the anesthesia code itself.
H50.9 – Unspecified Strabismus
May apply when anesthesia is provided for a qualifying strabismus procedure and the documentation supports this diagnosis.
H05.89 – Other Disorders of Orbit
May apply to certain orbital conditions requiring an eye procedure when the specific documented disorder is appropriately represented by this diagnosis.
C69.90 – Malignant Neoplasm of Unspecified Eye, Unspecified
May apply when an eye procedure requiring anesthesia is performed because of a documented malignant neoplasm and a more specific diagnosis is not supported by the record.
Applicable Modifiers
May be reported when the anesthesia service is personally performed by an anesthesiologist. It is applicable when it accurately represents the provider arrangement for the CPT 00140 service.
May be reported when a CRNA provides the anesthesia service with medical direction by a physician. Documentation must support the applicable medical-direction requirements.
May be used to identify monitored anesthesia care (MAC) when applicable to the eye procedure. QS is informational and does not replace the appropriate anesthesia payment modifier when one is required.
Related CPT Codes
CPT 00142 applies to anesthesia for lens surgery. It is an important alternative to CPT 00140 when the underlying eye procedure involves the lens.
CPT 00144 applies to anesthesia for corneal transplantation. It should be selected instead of the broader CPT 00140 when the documented procedure is a qualifying corneal transplant.
CPT 00145 applies to anesthesia for vitreoretinal surgery. It is closely related to CPT 00140 but provides a more specific anesthesia code for qualifying vitreoretinal procedures.
FAQ
What is CPT code 00140 used for?
CPT code 00140 is used for anesthesia during eye procedures when the underlying procedure is not represented by a more specific ophthalmic anesthesia code.
Is CPT 00140 used for cataract surgery?
CPT 00140 should not automatically be used for cataract surgery. When the procedure involves lens surgery and meets the applicable requirements, the more specific anesthesia code CPT 00142 should be considered.
Can CPT 00140 be used for strabismus surgery?
CPT 00140 may be appropriate for anesthesia associated with qualifying strabismus procedures when no more specific anesthesia code describes the service.
Can CPT 00140 be reported with monitored anesthesia care?
It may be appropriate when MAC is provided for a qualifying eye procedure. The documentation should support the anesthesia service, and applicable payer modifier requirements should be followed.
How is CPT 00140 reimbursement calculated?
Anesthesia reimbursement generally considers base units, documented anesthesia time, the applicable conversion factor, and payer-specific payment adjustments.
How do I choose between CPT 00140 and another eye anesthesia code?
Review the underlying ophthalmic procedure first. If a more specific anesthesia code describes the procedure, that code should generally be selected instead of the broader CPT 00140.
Category
CPT
Reimbursment
Hospital & ASC
Base Units + Time Units
Description
Code Type
Code
00140
Procedures on the eye
Anesthesia
Common Setting
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