CPT® Code 99135

Anesthesia complicated by utilization of controlled hypotension (List separately in addition to code for primary anesthesia procedure)

The CPT® Code 99135 is utilized to indicate a specific circumstance that complicates the administration of anesthesia during surgical procedures. This code is not intended to be reported independently; rather, it must be used in conjunction with the primary anesthesia procedure codes. The essence of this code lies in its application to situations where controlled hypotension is employed as part of the anesthesia management. Controlled hypotension refers to a deliberate reduction in blood pressure to minimize intraoperative blood loss, thereby enhancing the surgical field visibility and reducing the necessity for blood transfusions. This technique is characterized by a targeted decrease in the patient's mean arterial pressure by approximately 30%, or by lowering the systolic blood pressure to a range of 80-90 mmHg, or the mean arterial pressure to between 50-65 mmHg. Such management is particularly relevant in high-risk surgical environments, including spinal surgery, endoscopic microsurgery of the head, oromaxillofacial surgery, major orthopedic procedures, and cardiovascular surgeries. The use of this code reflects the additional complexities and risks associated with the anesthesia service provided under these specific conditions.