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00145
Anesthesia for Vitreoretinal Surgery Billing & Coding Guide
Code Description
CPT code 00145 reports anesthesia services provided for vitreoretinal surgery, including procedures involving the vitreous, retina, and posterior segment of the eye. The anesthesia provider performs the pre-anesthesia evaluation, administers anesthesia, continuously monitors the patient throughout the procedure, manages the airway when necessary, and provides post-anesthesia care until the patient is safely transferred to recovery.
This code is commonly reported for retinal detachment repair, vitrectomy, membrane peeling, macular hole repair, vitreous hemorrhage surgery, and other posterior segment procedures. Reimbursement is determined using anesthesia base units, documented anesthesia time, applicable physical status modifiers, and the payer's anesthesia conversion factor.
When to Use CPT 00145
Report 00145 when anesthesia services are provided for vitreoretinal surgery involving the retina or vitreous body. The anesthesia provider should document continuous care from induction through transfer to postoperative recovery.
When Not to Use CPT 00145
Do not report 00145 when another anesthesia CPT code more accurately describes the ophthalmic procedure or when anesthesia services are not personally provided or medically directed according to payer guidelines. This code should not be reported by the operating surgeon.
Documentation Requirements
Documentation should include the pre-anesthesia evaluation, anesthesia start and stop times, ASA physical status, medications administered, airway management when applicable, physiologic monitoring, patient response throughout the procedure, and the post-anesthesia evaluation. The operative report should clearly support that anesthesia was provided for vitreoretinal surgery.
Documentation Checklist
✔ Medical necessity documented
✔ Vitreoretinal procedure documented
✔ Pre-anesthesia evaluation completed
✔ Anesthesia start and stop times documented
✔ ASA physical status documented
✔ Complete anesthesia record maintained
Billing Examples
Example 1
An anesthesiologist administers general anesthesia for pars plana vitrectomy with retinal detachment repair. Report CPT code 00145 for the anesthesia service.
Example 2
A patient undergoes vitrectomy with membrane peeling for a macular pucker under general anesthesia. The anesthesia provider documents the complete anesthesia record and reports CPT code 00145.
Base Units & Reimbursement
Anesthesia reimbursement for CPT 00145 is calculated using anesthesia base units, documented anesthesia time units, and the payer's anesthesia conversion factor. Additional reimbursement may apply when qualifying circumstances are documented according to payer policy.
Accurate anesthesia start and stop times, complete documentation, and the appropriate ASA physical status modifier are essential for proper reimbursement.
Coding & Billing Tips
Document Accurate Anesthesia Time
Record anesthesia start and stop times accurately because reimbursement is partially based on total anesthesia time.
Verify the Surgical Procedure
Confirm the procedure involves vitreoretinal surgery before reporting CPT code 00145.
Maintain Complete Documentation
Ensure the anesthesia record includes the pre-anesthesia evaluation, medications administered, physiologic monitoring, and postoperative assessment.
Common Billing Mistakes
Reporting the Wrong Anesthesia Code
Verify the ophthalmic procedure is a vitreoretinal surgery and not another eye procedure assigned to a different anesthesia CPT code.
Incomplete Time Documentation
Failure to document anesthesia start and stop times accurately may reduce reimbursement or delay claim processing.
Incomplete Anesthesia Record
Missing documentation of ASA physical status, medications, monitoring, or postoperative evaluation may result in claim denial.
Applicable ICD-10-CM Diagnosis Codes
Diagnosis codes should accurately reflect the documented condition and support medical necessity. The examples below are not all-inclusive.
H33.20 – Retinal Detachment with Retinal Break, Unspecified Eye
This diagnosis may support medical necessity when anesthesia is provided for retinal detachment repair. Documentation should support the diagnosis and planned surgical procedure.
H35.371 – Epiretinal Membrane, Right Eye
This diagnosis may support medical necessity when vitrectomy with membrane peeling is performed. Documentation should describe the patient's visual impairment and surgical indication.
H43.11 – Vitreous Hemorrhage, Right Eye
This diagnosis may support medical necessity when vitrectomy is required to remove vitreous hemorrhage and preserve vision.
Related Codes
00140 – Anesthesia for Procedures on the Eye
Report 00140 for ophthalmic procedures when a more specific anesthesia CPT code does not apply.
00142 – Anesthesia for Lens Surgery
00142 describes anesthesia services provided during cataract and other lens surgery procedures.
00144 – Anesthesia for Corneal Transplant Surgery
00144 describes anesthesia services provided during corneal transplant procedures.
Frequently Asked Questions
How is CPT code 00145 reimbursed?
Reimbursement is based on anesthesia base units, anesthesia time, the payer's conversion factor, and applicable payment adjustments.
Does CPT code 00145 include anesthesia time?
Yes. Documented anesthesia time is included when calculating reimbursement.
Can a CRNA report CPT code 00145?
Yes. CRNAs may report CPT code 00145 when billing under applicable Medicare and commercial payer guidelines.
Is CPT code 00145 used for retinal detachment surgery?
Yes. CPT code 00145 is commonly reported for anesthesia provided during retinal detachment repair and other vitreoretinal procedures.
Can CPT code 00145 be reported for vitrectomy?
Yes. Vitrectomy procedures involving the vitreous or retina are commonly reported with CPT code 00145 when anesthesia services are provided.
Category
CPT
Reimbursment
Hospital & ASC
Base Units + Time Units
Description
Code Type
Code
00145
Vitreoretinal surgery
Anesthesia
Common Setting
