CPT Code 00142
Anesthesia for Lens Surgery Billing & Coding Guide
Code Description
CPT code 00142 is used for anesthesia services associated with lens surgery.
A common application is anesthesia during cataract extraction with or without placement of an intraocular lens. The anesthesia professional evaluates the patient, develops the anesthesia plan, administers or manages the appropriate anesthesia service, monitors the patient's physiologic status, and oversees recovery.
Lens procedures are often performed using local or regional anesthesia combined with monitored anesthesia care (MAC), although the anesthesia technique depends on the patient, procedure, and clinical circumstances.
Code selection should be based on the actual surgical procedure. CPT 00142 should not be used simply because surgery involves the eye when the procedure does not involve the lens.
When to Use CPT 00142
Use CPT code 00142 when an anesthesia professional provides anesthesia for a qualifying surgical procedure involving the lens of the eye.
Common situations may include:
Cataract extraction
Cataract extraction with intraocular lens placement
Complex cataract surgery
Other qualifying procedures involving the ocular lens
Lens procedures performed under monitored anesthesia care or another appropriate anesthesia technique
The operative report should clearly establish that the procedure involves lens surgery. The anesthesia record should separately document the anesthesia service provided.
When NOT to Use CPT Code 00142
Do not report CPT code 00142 when:
The procedure does not involve the lens.
A different ophthalmic anesthesia code more accurately describes the procedure.
The patient undergoes corneal transplantation.
The procedure involves vitreoretinal surgery rather than lens surgery.
Only local anesthesia administered by the surgeon is provided without a separately reportable anesthesia service.
Documentation does not support the anesthesia service.
CPT 00142 should be distinguished from broader eye anesthesia codes and codes describing anesthesia for specific ophthalmic procedures.
Documentation Requirements
Documentation should clearly support both the lens procedure and the anesthesia service and include:
Specific lens procedure performed
Eye involved when documented
Medical necessity for the procedure
Pre-anesthesia evaluation
Anesthesia plan
Type of anesthesia provided
Anesthetic medications administered
Physiologic monitoring
Airway management when applicable
Anesthesia start and stop times
Patient response to anesthesia
Post-anesthesia evaluation and recovery
The operative report should establish that the underlying procedure involves the lens. The anesthesia record should independently support the professional anesthesia service.
When monitored anesthesia care is provided, the documentation should support the anesthesia professional's continuous presence and monitoring according to applicable requirements.
Documentation Checklist
Before submitting CPT code 00142, confirm that the medical record includes:
✓ Lens surgery documented
✓ Medical necessity supported
✓ Eye involved documented when applicable
✓ Pre-anesthesia evaluation completed
✓ Anesthesia plan documented
✓ Type of anesthesia documented
✓ Anesthesia start and stop times recorded
✓ Physiologic monitoring documented
✓ Post-anesthesia recovery documented
Examples
Example 1
A patient with an age-related cataract undergoes cataract extraction with placement of an intraocular lens. An anesthesia professional provides monitored anesthesia care, continuously monitors the patient, and documents anesthesia time and recovery. CPT code 00142 is reported for the anesthesia service.
Example 2
A patient undergoes complex cataract surgery requiring an anesthesia professional because of the patient's medical condition and procedural needs. The anesthesia record documents the pre-anesthesia assessment, medications, monitoring, anesthesia time, and recovery. CPT code 00142 is reported.
Example 3
A patient undergoes a qualifying lens procedure under anesthesia. The anesthesia professional completes the preoperative assessment, administers anesthesia, monitors the patient's physiologic status throughout the procedure, and supervises recovery. CPT code 00142 may be reported when the documentation supports the service.
Base Units & Reimbursement
Anesthesia reimbursement for CPT 00142 generally considers the anesthesia 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. Payment can also vary based on geographic adjustments, the anesthesia provider arrangement, medical direction, qualifying circumstances, and payer-specific policies.
Accurate anesthesia start and stop times are important even when the lens procedure is relatively brief. Surgical procedure time should not automatically be substituted for anesthesia time.
Coding & Billing Tips
Confirm that the underlying procedure involves the lens before using CPT 00142.
Cataract extraction is a common procedure associated with CPT 00142.
Do not automatically use a general eye anesthesia code when a more specific lens surgery code applies.
Document whether MAC, general anesthesia, or another anesthesia technique was provided.
Record anesthesia start and stop times accurately.
Link the diagnosis to the actual lens condition being treated.
Apply anesthesia and MAC modifiers only when supported by the service and payer requirements.
Common Billing Mistakes
Using a general eye anesthesia code for lens surgery
When the documented procedure is lens surgery, CPT 00142 provides a more specific anesthesia code than a general anesthesia code for procedures on the eye.
Coding from the diagnosis instead of the procedure
A cataract diagnosis alone does not establish CPT 00142. The medical record must show that a qualifying lens procedure requiring anesthesia was performed.
Separately billing anesthesia provided by the surgeon
When the surgeon performing the lens procedure also provides anesthesia that is considered part of the surgical service, a separate anesthesia service may not be reportable. Separate anesthesia billing should reflect a qualifying anesthesia service.
Reporting inaccurate anesthesia time
The anesthesia record should support the start and stop times reported on the claim. Procedure duration should not automatically be used as anesthesia time.
Insufficient MAC documentation
When monitored anesthesia care is provided, documentation should support the anesthesia professional's involvement, monitoring, and management of the patient.
Using the wrong ophthalmic anesthesia code
Corneal transplantation, vitreoretinal surgery, and other specific eye procedures may have different anesthesia codes. The operative procedure should be reviewed before code selection.
Common ICD-10-CM Codes
H25.9 – Unspecified Age-Related Cataract
May apply when lens surgery is performed for an age-related cataract and the medical record does not support a more specific cataract diagnosis.
H26.9 – Unspecified Cataract
May apply when cataract surgery is performed and the documented cataract is not identified as a more specific type.
T85.22XA – Displacement of Intraocular Lens, Initial Encounter
May apply when qualifying lens-related surgery is required because of displacement of an intraocular lens and the documentation supports the diagnosis and encounter designation.
Applicable Modifiers
May be reported when the anesthesia service for lens surgery is personally performed by an anesthesiologist. The modifier should reflect the actual anesthesia provider arrangement.
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 useful when monitored anesthesia care is provided during lens surgery. QS identifies MAC and may be particularly relevant to cataract and other lens procedures performed with monitored anesthesia care. It is informational and does not replace an applicable anesthesia payment modifier.
Related CPT Codes
66984
CPT 66984 is a commonly associated surgical code for cataract extraction with insertion of an intraocular lens. CPT 00142 represents the anesthesia service rather than the cataract procedure itself.
CPT 00140 is used for anesthesia during qualifying eye procedures not represented by a more specific ophthalmic anesthesia code. CPT 00142 is more specific when the underlying procedure involves lens surgery.
CPT 00144 applies to anesthesia for corneal transplantation. It is useful for distinguishing anesthesia for corneal procedures from anesthesia for lens surgery.
FAQ
What is CPT code 00142 used for?
CPT code 00142 is used to report anesthesia services provided during qualifying procedures involving the lens of the eye.
Is CPT 00142 used for cataract surgery?
Yes. Cataract extraction is one of the most common lens procedures for which CPT 00142 may represent the anesthesia service.
Can CPT 00142 be used with monitored anesthesia care?
Yes, when a qualifying anesthesia professional provides MAC during lens surgery and the service is supported by the documentation and payer requirements.
Is CPT 00142 the same as the cataract surgery code?
No. CPT 00142 represents anesthesia for lens surgery. The underlying cataract or lens procedure is reported with the appropriate surgical CPT code.
How is CPT 00142 reimbursement calculated?
Anesthesia reimbursement generally considers base units, documented anesthesia time, the applicable conversion factor, and payer-specific payment adjustments.
How is CPT 00142 different from CPT 00140?
CPT 00142 specifically applies to anesthesia for lens surgery, while CPT 00140 is a broader anesthesia code for qualifying eye procedures when a more specific ophthalmic anesthesia code does not apply.
Category
CPT
Reimbursment
Hospital & ASC
Base Units + Time Units
Description
Code Type
Code
00142
Lens surgery
Anesthesia
Common Setting
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