{"id":168468,"date":"2026-07-28T13:36:13","date_gmt":"2026-07-28T13:36:13","guid":{"rendered":"https:\/\/pabau.com\/?p=168468"},"modified":"2026-08-17T11:37:05","modified_gmt":"2026-08-17T11:37:05","slug":"cpt-code-00546","status":"publish","type":"post","link":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/","title":{"rendered":"CPT Code 00546: Anesthesia for pulmonary resection with thoracoplasty"},"content":{"rendered":"\n<script type=\"application\/ld+json\">{\"@context\":\"https:\/\/schema.org\",\"@type\":\"MedicalWebPage\",\"headline\":\"CPT Code 00546: Anesthesia for pulmonary resection with thoracoplasty\",\"description\":\"Complete billing reference for CPT Code 00546 (anesthesia for thoracotomy procedures involving pulmonary resection combined with thoracoplasty). Covers base units, modifiers, Medicare reimbursement, ICD-10 crosswalk, and documentation requirements.\",\"url\":\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00546\/\",\"audience\":{\"@type\":\"MedicalAudience\",\"audienceType\":\"Clinician\"},\"reviewedBy\":{\"@type\":\"Person\",\"name\":\"Dr Vanja Kitanova\",\"jobTitle\":\"Medical Reviewer\",\"affiliation\":{\"@type\":\"Organization\",\"name\":\"Pabau\"},\"knowsAbout\":[\"Medical Coding\",\"Clinical Documentation\",\"Healthcare Billing\",\"Clinical Safety\"],\"sameAs\":\"https:\/\/pabau.com\/blog\/author\/vanja\/\"},\"datePublished\":\"2026-07-28\",\"dateModified\":\"2026-07-28\"}<\/script>\n\n\n        <div id=\"key_takeaways\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/12\/Key-Takeaways-Icon.svg\" alt=\"Key takeaways\" height=\"42\" width=\"42\">\n                                <h3>Key takeaways<\/h3>\n            <\/div>\n            <div class=\"list\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>CPT Code 00546 covers anesthesia for thoracotomy procedures on the lungs, pleura, diaphragm, and mediastinum when pulmonary resection is performed together with thoracoplasty.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>This code carries 15 anesthesia base units, higher than the 12 base units assigned to CPT 00540, the standalone code for unspecified thoracotomy procedures.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Modifier selection is the most common denial trigger. Modifier AA applies when an anesthesiologist personally performs the service, while QK, QX, QY, or QZ apply under anesthesia care team and CRNA arrangements.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#3D3D46\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p>Practice management software like Pabau keeps pre-anesthesia evaluations, operative notes, and diagnosis documentation together in one patient record, supporting accurate CPT Code 00546 claims.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<p class=\"wp-block-paragraph\">CPT Code 00546 is the anesthesia code for thoracotomy procedures involving the lungs, pleura, diaphragm, and mediastinum. It applies when the surgeon performs pulmonary resection together with thoracoplasty, and it carries 15 base anesthesia units within the 00540-00548 thoracotomy and thoracoscopy sub-group.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This reference guide covers the official descriptor, base unit value, and applicable modifiers. It also covers the Medicare reimbursement formula, ICD-10 crosswalk, related thoracotomy codes, and documentation requirements that most billing references skip. Anesthesia coders, billing specialists.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">CPT Code 00546: definition, descriptor, and clinical context<\/h2>\n\n\n\n<figure class=\"wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio\">\n<div class=\"wp-block-embed__wrapper\">\n<iframe title=\"CPT Coding Pitfalls Every Medical Practice Faces\" width=\"800\" height=\"450\" src=\"https:\/\/www.youtube.com\/embed\/vbvV5okdXKg?feature=oembed\" frameborder=\"0\" allow=\"accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share\" referrerpolicy=\"strict-origin-when-cross-origin\" allowfullscreen><\/iframe>\n<\/div>\n<\/figure>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Field<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Detail<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">CPT Code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">00546<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Official descriptor<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code section<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for intrathoracic procedures (00500-00580)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code family<\/td>\n<td style=\"padding:12px 16px;color:#374151\">00540-00548 &mdash; five standalone codes in the thoracotomy\/thoracoscopy sub-group; not a parent\/child hierarchy<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Base anesthesia units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">15<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Code type<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia (Section 00100-01999)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Maintained by<\/td>\n<td style=\"padding:12px 16px;color:#374151\">American Medical Association (AMA)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The key clinical requirement for 00546 is that the operative report documents <strong>pulmonary resection performed together with thoracoplasty<\/strong> &mdash; not either procedure alone. Thoracoplasty involves the surgical removal or collapse of ribs to reduce the volume of the chest cavity. This typically closes a space left after lung tissue is removed. The code is selected by the procedure the surgeon performs, not by the patient\u2019s underlying lung physiology. A patient\u2019s overall respiratory status is instead captured separately, through the ASA physical status modifier (P1-P6) attached to the anesthesia claim. The added complexity of combining resection with chest-wall surgery is why this code carries 15 base units, per the <a href=\"https:\/\/www.ama-assn.org\/practice-management\/cpt\/cpt-code-set-overview\" target=\"_blank\" rel=\"nofollow noopener\">AMA CPT code set<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Anesthesia base units and the reimbursement formula<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 00546 carries <strong>15 anesthesia base units<\/strong>. This value reflects the relative complexity of anesthesia services compared to other procedures. Base units alone do not determine reimbursement: Medicare and most commercial payers use a formula that combines base units with time units.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The standard formula, as outlined in the <a href=\"https:\/\/www.cms.gov\/medicare\/physician-fee-schedule\/search\/overview\" target=\"_blank\" rel=\"nofollow noopener\">CMS Physician Fee Schedule<\/a>, is:<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Formula component<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Value for 00546 example<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Base units (B)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Fixed value assigned to the CPT code<\/td>\n<td style=\"padding:12px 16px;color:#374151\">15<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Time units (T)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">1 unit per 15 minutes of anesthesia time (typical; payer contracts may differ)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">8 (for a 120-minute procedure)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Qualifying circumstance units (M)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Add-on codes (99100, 99140) when applicable<\/td>\n<td style=\"padding:12px 16px;color:#374151\">0 (if none apply)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Conversion factor (CF)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Medicare locality-specific dollar rate per unit; updated annually by CMS<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Varies by locality<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Payment<\/td>\n<td style=\"padding:12px 16px;color:#374151\">(B + T + M) x CF<\/td>\n<td style=\"padding:12px 16px;color:#374151\">(15 + 8 + 0) x CF = 23 x CF<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Time unit documentation is where many 00546 claims fail audit. The anesthesia start and stop times must be recorded in the anesthesia record and must match the time units billed. A two-hour procedure billed as 10 time units (150 minutes) without supporting documentation will trigger a take-back. Practice management software like Pabau keeps the pre-anesthesia evaluation, operative note, and anesthesia record together in one patient file. That makes it easier to confirm the documented times match what\u2019s billed before a claim goes out.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img decoding=\"async\" src=\"https:\/\/cdn.pabau.com\/cdn\/attachments\/pulse\/content-engine\/billing_codes\/cpt-code-00546\/track-claims-from-start-to-finish.webp\" alt=\"Pabau claims dashboard showing claims grouped by status\"\/><figcaption class=\"wp-element-caption\"><em>Pabau\u2019s claims dashboard groups every claim by status, so billing teams can catch a stalled or rejected CPT Code 00546 claim before it delays reimbursement.<\/em><\/figcaption><\/figure>\n\n\n\n<div style=\"height:35px;width:800px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n\n\n<h2 class=\"wp-block-heading\">Medicare reimbursement and fee schedule for CPT Code 00546<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medicare calculates anesthesia payments using the base-plus-time formula above, multiplied by a geographic locality conversion factor. The conversion factor is updated annually in the Medicare Physician Fee Schedule. It varies by state and by locality within states. Billing teams should always pull the current-year rate from the CMS fee schedule lookup tool rather than relying on prior-year figures. A single percentage-point change in the CF alters payment on every unit billed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Unlike codes on the standard Medicare Physician Fee Schedule, anesthesia codes such as 00546 are not priced through the work\/practice-expense\/malpractice RVU methodology. They also carry no facility versus non-facility split. Payment instead uses the base-plus-time formula above, multiplied by the same locality conversion factor regardless of setting.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A thoracotomy combining pulmonary resection with thoracoplasty is a major procedure. It would essentially never be performed outside a hospital or ambulatory surgical center. As a result, the facility\/non-facility distinction that applies to standard physician fee schedule codes does not come into play for this code in practice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">For Medicare Advantage plans and commercial payers, rates are negotiated separately and may differ substantially from Medicare fee schedule amounts. Always verify the applicable contract rate before estimating expected reimbursement for CPT Code 00546.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because anesthesia claims hinge on time units and modifiers, <a href=\"https:\/\/pabau.com\/features\/claims-management-software\/\">claims management software<\/a> helps catch errors before payers do.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Applicable modifiers for CPT Code 00546<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Modifier selection is the single most common reason CPT Code 00546 claims are denied. The correct modifier depends on who performed the anesthesia service and under what supervision arrangement. The Centers for Medicare and Medicaid Services (CMS) specifies these distinctions in Chapter 12 of the Medicare Claims Processing Manual.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Modifier<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Billing scenario<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Payment impact<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">AA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist personally performs the service<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Solo anesthesiologist with no CRNA or resident involvement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of the allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QK<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist medically directs two to four CRNAs or residents<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia care team (ACT) with medical direction of up to four concurrent procedures<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of the allowed amount (Medicare ACT rate)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QX<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA service under medical direction of a physician<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA performing the service; anesthesiologist medically directing<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of the allowed amount (CRNA component)<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QY<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesiologist medically directs a single CRNA<\/td>\n<td style=\"padding:12px 16px;color:#374151\">One-to-one medical direction arrangement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">50% of the allowed amount<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">QZ<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA service without medical direction<\/td>\n<td style=\"padding:12px 16px;color:#374151\">CRNA performing independently, no anesthesiologist medically directing<\/td>\n<td style=\"padding:12px 16px;color:#374151\">100% of the allowed amount (CRNA bills independently)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The anesthesiologist bills QK and the CRNA bills QX on the same claim, and both submit simultaneously. Together, the two modifiers add up to 100% of the Medicare allowed amount. A common error is billing modifier AA when a CRNA was involved in any capacity. This misrepresents the service and creates a billing compliance risk under the False Claims Act.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CRNA scope of practice and billing authority under modifier QZ varies by state law. In opt-out states, CRNAs may bill 100% of the Medicare anesthesia fee without physician oversight. In non-opt-out states, the medical direction rules apply. Always confirm current state opt-out status before billing QZ for CPT Code 00546. Learn more about HIPAA-compliant billing workflows when managing these arrangements.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">ICD-10 codes commonly paired with CPT Code 00546<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Medical necessity for CPT Code 00546 hinges on the diagnosis code submitted with the claim. That diagnosis needs to support pulmonary resection combined with thoracoplasty specifically, not just a generic thoracic diagnosis. Payers look for ICD-10 codes tied to the conditions that most often require this combined procedure: chronic empyema, bronchiectasis, tuberculous cavitary disease, and thoracic malignancy. Submitting a diagnosis that only supports a resection, or only supports chest-wall surgery, without documentation that both were needed together, is a common crosswalk error. This error triggers medical necessity denials.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">ICD-10-CM Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Description<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Relevance to 00546<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J86.9<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pyothorax (empyema) without fistula<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Chronic empyema is a common indication for pulmonary resection combined with thoracoplasty to close the residual pleural space<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J86.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Pyothorax with fistula<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Supports thoracoplasty when a persistent bronchopleural fistula follows resection<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J47.9<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Bronchiectasis, uncomplicated<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Localized bronchiectasis unresponsive to medical management may require resection with thoracoplasty<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">A15.0<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Tuberculosis of lung<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cavitary TB disease is a recognized indication for pulmonary resection combined with thoracoplasty<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">C34.90<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Malignant neoplasm of unspecified part of unspecified bronchus or lung<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Supports resection for thoracic malignancy when combined with thoracoplasty to obliterate the surgical space<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">J98.4<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Other disorders of lung<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Broader residual category, used only when documentation still ties it to pulmonary resection with thoracoplasty<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">Always use the most specific ICD-10-CM code available. &#8220;Unspecified&#8221; codes are acceptable when clinical documentation does not support a more granular diagnosis, but they invite additional documentation requests from payers. The same specificity principle applies across unrelated ICD-10-CM crosswalks. A useful reference is the <a href=\"https:\/\/www.aapc.com\/codify\/icd-10-crosswalk.aspx\" target=\"_blank\" rel=\"nofollow noopener\">AAPC CPT-to-ICD-10 crosswalk tool<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">CPT 00546 in the thoracotomy anesthesia code family<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 00546 sits within the thoracotomy subsection of the anesthesia code range. Understanding the sibling codes matters for accurate code selection. Choosing the wrong code within this family because of a shared procedure type is a common selection error. The codes below cover different clinical scenarios under the same surgical approach.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">CPT Code<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Descriptor<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Base units<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Key distinction<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00540<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (not otherwise specified)<\/td>\n<td style=\"padding:12px 16px;color:#374151\">12<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Standalone code; use when no more specific code in the 00540-00548 sub-group applies<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00541<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for thoracotomy procedures involving single-lung ventilation<\/td>\n<td style=\"padding:12px 16px;color:#374151\">15<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Applies when single-lung ventilation is the defining clinical trigger, regardless of diagnosis<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00542<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum; decortication<\/td>\n<td style=\"padding:12px 16px;color:#374151\">15<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Specific to decortication &mdash; removal of the fibrous pleural peel in chronic empyema or a trapped lung<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00546<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum (including surgical thoracoscopy); pulmonary resection with thoracoplasty<\/td>\n<td style=\"padding:12px 16px;color:#374151\">15<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Requires documented pulmonary resection combined with thoracoplasty; not indicated for resection or thoracoplasty alone<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">00548<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Anesthesia for intrathoracic procedures on the trachea and bronchi<\/td>\n<td style=\"padding:12px 16px;color:#374151\">17<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Specific to procedures on the trachea and bronchi, not lung resection<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">The selection between 00540 and 00546 trips up even experienced coders. The deciding factor is whether the operative note documents pulmonary resection performed together with thoracoplasty, not the patient\u2019s underlying lung pathology. When both are present, 00546 applies. When the note describes a thoracotomy that doesn\u2019t fit any of the more specific codes in this sub-group, 00540 is the correct choice.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Cardiothoracic anesthesia billing extends beyond this sub-group too. CPT 00566 covers anesthesia for off-pump coronary artery bypass grafting, a related but separate code family. For a broader procedure code lookup, billing teams can also consult the <a href=\"https:\/\/www.aapc.com\/codes\/cpt-codes-range\/\" target=\"_blank\" rel=\"nofollow noopener\">AAPC Codify CPT lookup<\/a>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Documentation requirements for CPT Code 00546 claims<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Most CPT code reference pages stop at the base units and modifiers. The documentation requirements are where practices lose money in post-payment audits. For CPT Code 00546, the anesthesia record must support three distinct billing elements. These are the procedure performed, the time billed, and the medical necessity of anesthesia for a procedure combining pulmonary resection with thoracoplasty.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">CMS requires the following documentation for a clean anesthesia claim:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li><strong>Pre-anesthesia evaluation:<\/strong> Documented before the procedure, covering the patient&#8217;s history, physical status (ASA classification), airway assessment, and planned anesthetic technique. This must be a separate note, not embedded in the surgical H&amp;P.<\/li><li><strong>Anesthesia record (intraoperative):<\/strong> Continuous time-stamped monitoring of vital signs, drug administration, ventilator settings, and the anesthetist identity. Start and stop times must be explicitly recorded.<\/li><li><strong>Post-anesthesia note:<\/strong> A discharge evaluation documenting the patient&#8217;s status and any post-operative complications or concerns. Required within a defined period after emergence from anesthesia.<\/li><li><strong>Diagnosis documentation:<\/strong> The operative report must confirm that pulmonary resection was performed together with thoracoplasty, not either procedure alone. &#8220;Pulmonary resection with thoracoplasty for chronic empyema&#8221; in the surgeon&#8217;s note directly supports 00546. A note referencing only thoracoplasty, or only a resection, without linking the two, fails to establish medical necessity for 00546.<\/li><li><strong>Modifier justification:<\/strong> If billing under QK\/QX (ACT arrangement), the record must document that the anesthesiologist met all seven conditions for medical direction during the case.<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Practices that use standardized pre-anesthesia evaluation forms within their clinical documentation workflow reduce the risk of audit deficiencies. A template that prompts for ASA classification, airway assessment, and procedure-specific risk factors ensures nothing is omitted. For guidance on maintaining medical office compliance documentation standards, CMS&#8217;s Claims Processing Manual Chapter 12 is the authoritative reference.<\/p>\n\n\n        <div id=\"pro_tip\">\n            <div class=\"img\">\n                <svg width=\"42\" height=\"42\" viewBox=\"0 0 42 42\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M12.6383 19.5238C12.6632 21.2071 12.8734 22.9926 12.0685 24.5523C11.0341 26.8917 8.45076 28.169 7.56292 30.5918C6.63082 33.1061 7.19505 36.185 9.31371 37.9786C10.929 39.5678 13.4183 39.9873 15.6061 39.5463C17.4592 39.073 19.1049 37.8388 19.9706 36.1608C20.781 34.7141 20.7866 32.9904 20.5293 31.3985C20.1006 29.3092 18.3775 27.8705 16.9807 26.362C14.8814 24.1005 14.6684 20.6854 15.595 17.8915C16.4331 15.4768 19.0026 14.2344 20.0425 11.9461C20.7202 10.6769 20.7506 9.20327 20.6068 7.81304C20.1864 5.40098 18.3139 3.23631 15.8716 2.56674C13.9742 2.03969 11.8224 2.30052 10.1739 3.37614C8.70522 4.34688 7.5878 5.86618 7.28356 7.58178C6.76081 9.82981 7.53525 12.2822 9.20307 13.9118C10.7658 15.4741 12.4806 17.2273 12.6383 19.5238Z\"\n                        fill=\"#2BADD4\" \/>\n                    <path fill-rule=\"evenodd\" clip-rule=\"evenodd\"\n                        d=\"M22.7048 19.8387C22.6822 22.3279 24.4507 24.6234 26.7493 25.4682C28.0531 25.961 29.4725 25.9183 30.7989 25.5487C32.0575 24.9955 33.301 24.2237 34.0069 23.0092C34.8384 21.5811 35.2982 19.8286 34.7832 18.2094C34.3611 16.2507 32.8739 14.6541 31.0275 13.9426C28.6736 12.9595 25.8073 13.7942 24.1719 15.7001C23.2022 16.8366 22.6143 18.3326 22.7048 19.8387Z\"\n                        fill=\"#2BADD4\" \/>\n                <\/svg>\n            <\/div>\n            <div class=\"text\">\n                <h3>Pro Tip<\/h3>\n                <p>Before submitting CPT Code 00546 claims, run a pre-submission check. Confirm the anesthesia start and stop times are documented. Confirm the ICD-10 diagnosis supports pulmonary resection combined with thoracoplasty. Confirm the modifier reflects the actual anesthesia care arrangement. These three checks resolve most first-submission denials for this code.<\/p>\n            <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Common billing errors and denial reasons for CPT Code 00546<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Denials on CPT Code 00546 cluster around four patterns. Each is preventable with the right process controls in place.<\/p>\n\n\n\n<table style=\"width:100%;border-collapse:separate;border-spacing:0;border-radius:12px;overflow:hidden;font-size:15px;line-height:1.5;margin:1.5em 0 2em;box-shadow:0 2px 12px rgba(0,0,0,0.08)\">\n<thead>\n<tr>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Error type<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">What goes wrong<\/th>\n<th style=\"background:#121D36;color:#fff;padding:14px 16px;text-align:left;font-weight:600;font-size:14px;letter-spacing:0.3px;border-bottom:2px solid #2BADD4\">Prevention<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Wrong modifier<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Billing AA when a CRNA was involved; or missing QX on the CRNA&#8217;s claim in an ACT arrangement<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Verify the care arrangement before billing; QK and QX must both be submitted for ACT cases<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Incorrect time units<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Time units billed do not match the start\/stop times in the anesthesia record<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Cross-check billed units against documented times before submission<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">ICD-10 mismatch<\/td>\n<td style=\"padding:12px 16px;color:#374151\">A diagnosis that only supports a resection or only supports chest-wall surgery is submitted, instead of one confirming both were performed together<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Map the surgeon&#8217;s operative note diagnosis to the correct ICD-10-CM code before submitting 00546<\/td>\n<\/tr>\n<tr style=\"border-bottom:1px solid #E8ECF0;background:#F9FAFB\">\n<td style=\"padding:12px 16px;font-weight:600;color:#121D36\">Missing pre-auth<\/td>\n<td style=\"padding:12px 16px;color:#374151\">High-complexity thoracic procedures require prior authorization from many commercial payers; missing auth results in automatic denial<\/td>\n<td style=\"padding:12px 16px;color:#374151\">Check payer-specific prior authorization requirements at scheduling; do not assume Medicare rules apply to commercial plans<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n\n\n\n<p class=\"wp-block-paragraph\">When denials do occur, the remittance advice code points directly to the root cause. CARC-4 (&#8220;the procedure code is inconsistent with the modifier used, or a required modifier is missing&#8221;) points to the modifier error covered above. CARC-16 (claim lacks information) points to missing documentation.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">RARC MA130 means the claim itself contains incomplete or invalid information and cannot be processed at all. This is not a prior-authorization denial. A missing authorization typically comes back as CARC-197 instead.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tracking denial patterns by code helps billing managers identify whether the issue is systematic or case-specific. The same modifier and documentation scrutiny applies to other anesthesia codes.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices that keep operative notes, ICD-10 codes, and modifier details together in one patient record catch more mismatches before submission. That beats catching them after a denial comes back. <\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Related CPT codes<\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00400\/\">CPT code 00400 \u2014 Anesthesia for integumentary system procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00100\/\">CPT Code 00100 \u2014 Anesthesia for salivary gland procedures<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00102\/\">CPT Code 00102 \u2014 Anesthesia for cleft lip repair<\/a><\/li>\n\n\n<li><a href=\"https:\/\/pabau.com\/procedure-codes\/cpt-code-00103\/\">CPT code 00103 \u2014 Anesthesia for eyelid reconstruction<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">How Pabau keeps thoracic anesthesia documentation in one place<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Anesthesia billing for a procedure like CPT Code 00546 touches a lot of separate records:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The pre-anesthesia evaluation<\/li><li>The surgeon\u2019s operative note<\/li><li>The anesthesia record with start and stop times<\/li><li>The ICD-10 diagnosis that has to match all of it<\/li><\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">When those live in different systems, or on paper, it\u2019s easy for one detail to drift out of sync before a claim goes out.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practice management software like Pabau keeps a patient\u2019s full clinical record \u2014 evaluations, treatment notes, and supporting documentation \u2014 in a single digital file. That beats splitting the same information across paper charts and a separate billing system.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This makes it faster to confirm that a diagnosis, an operative note, and a recorded time all tell the same story. That check happens before the claim leaves the building.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The result is fewer last-minute scrambles to track down a missing note before a submission deadline. It also means fewer claims come back because two documents in the file didn\u2019t agree. For a code family with as many moving parts as anesthesia billing, that consistency is worth having.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices in plastic surgery and physical therapy face similar pressure to keep procedure notes, diagnosis codes, and treatment records aligned before a claim goes out. That same discipline is what makes CPT Code 00546 claims easier to defend.<\/p>\n\n\n        <div id=\"book_a_demo\">\n            <div class=\"left-side\">\n                <div class=\"logo\">\n                    <img decoding=\"async\"\n                        src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Logo.svg\"\n                        alt=\"Logo\"\n                        loading=\"lazy\"\n                    \/>\n                <\/div>\n\n                <h3 class=\"heading\">\n                    Keep thoracic anesthesia documentation audit-ready                <\/h3>\n\n                <p class=\"description\">\n                    Pabau brings pre-anesthesia evaluations, operative notes, and diagnosis documentation together in one patient record, so your team can confirm every detail matches the claim before it goes out.                <\/p>\n\n                <div class=\"button-group\">\n                    <a href=\"\/book-demo\/\" class=\"btn btn-scale-effect btn-cta-color btn-md\">\n                        <span class=\"btn-text\">Book a demo<\/span>\n                        <div class=\"btn-icon btn-icon-right\" aria-hidden=\"true\">\n                            <svg\n                                width=\"14\"\n                                height=\"12\"\n                                viewBox=\"0 0 14 12\"\n                                fill=\"none\"\n                                xmlns=\"http:\/\/www.w3.org\/2000\/svg\"\n                            >\n                                <path\n                                    d=\"M0.75 4.77295C0.335786 4.77295 0 5.10874 0 5.52295C0 5.93716 0.335786 6.27295 0.75 6.27295V5.52295V4.77295ZM13.2803 6.05328C13.5732 5.76039 13.5732 5.28551 13.2803 4.99262L8.50736 0.219648C8.21447 -0.073245 7.73959 -0.073245 7.4467 0.219648C7.15381 0.512542 7.15381 0.987415 7.4467 1.28031L11.6893 5.52295L7.4467 9.76559C7.15381 10.0585 7.15381 10.5334 7.4467 10.8263C7.73959 11.1191 8.21447 11.1191 8.50736 10.8263L13.2803 6.05328ZM0.75 5.52295V6.27295L12.75 6.27295V5.52295V4.77295L0.75 4.77295V5.52295Z\"\n                                    fill=\"currentColor\"\n                                ><\/path>\n                            <\/svg>\n                        <\/div>\n                    <\/a>\n                <\/div>\n            <\/div>\n\n            <div class=\"right-side\">\n                <img decoding=\"async\"\n                    src=\"https:\/\/pabau.com\/wp-content\/uploads\/2026\/01\/Home-Page-Concept-4.webp\"\n                    alt=\"Pabau clinic management dashboard\"\n                    loading=\"lazy\"\n                \/>\n            <\/div>\n        <\/div>\n        \n\n\n<h2 class=\"wp-block-heading\">Conclusion<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">CPT Code 00546 rewards precision over speed. The code exists for one specific combination: pulmonary resection performed together with thoracoplasty. Billing it correctly means resisting the urge to reach for 15 units whenever a thoracotomy looks complex enough to justify them.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Get the underlying procedure right, and the rest of the claim tends to follow. The ICD-10 code aligns with a condition that calls for the combined procedure. The modifier reflects who was really in the room, and the documented time matches what\u2019s billed. Skip that first step, and no amount of clean paperwork elsewhere in the claim will save it from a medical necessity denial.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Practices that build this check into their pre-submission workflow, rather than their appeals process, see the difference in first-pass acceptance rates. <a href=\"https:\/\/pabau.com\/book-demo\/\">Book a demo<\/a> to see how Pabau keeps thoracic anesthesia documentation consistent from the pre-anesthesia evaluation through to the claim.<\/p>\n\n\n        <div id=\"expert_picks\">\n            <div class=\"header\">\n                                    <img decoding=\"async\" src=\"https:\/\/pabau.com\/wp-content\/uploads\/2025\/11\/Expert-Picks.svg\" alt=\"Continue your research\" height=\"42\" width=\"42\">\n                                <h3>Continue your research<\/h3>\n            <\/div>\n            <div class=\"content\">\n                                                            <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Need a billing reference for related anesthesia codes?<\/strong> <a href=\"https:\/\/pabau.com\/procedure-codes\/coaching-cpt-codes\/\" target=\"_blank\" rel=\"noopener\">Coaching CPT codes<\/a> provides an additional CPT billing reference covering documentation requirements and modifier application across outpatient procedure codes.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Looking to streamline pre-anesthesia intake documentation?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/medical-forms-at-your-healthcare-practice\/\" target=\"_blank\" rel=\"noopener\">Medical forms for healthcare practices<\/a> covers how standardized digital forms reduce missing documentation and audit risk for clinical procedures.<\/p>\n                        <\/div>\n                                                                                <div class=\"item\">\n                            <div>\n                                <svg width=\"20\" height=\"27\" viewBox=\"0 0 20 27\" fill=\"none\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\">\n                                    <path\n                                        d=\"M18.6223 14.3857C19.1246 13.8975 19.1246 13.1045 18.6223 12.6162L12.1938 6.36621C11.6915 5.87793 10.8759 5.87793 10.3737 6.36621C9.87143 6.85449 9.87143 7.64746 10.3737 8.13574L14.6125 12.2529H2.28571C1.57455 12.2529 1 12.8115 1 13.5029C1 14.1943 1.57455 14.7529 2.28571 14.7529H14.6085L10.3777 18.8701C9.87545 19.3584 9.87545 20.1514 10.3777 20.6396C10.8799 21.1279 11.6955 21.1279 12.1978 20.6396L18.6263 14.3896L18.6223 14.3857Z\"\n                                        fill=\"#54B2D3\" \/>\n                                <\/svg>\n                            <\/div>\n                            <p><strong>Managing HIPAA compliance across your billing team?<\/strong> <a href=\"https:\/\/pabau.com\/blog\/hipaa-and-social-media\/\" target=\"_blank\" rel=\"noopener\">HIPAA and social media<\/a> outlines the patient data handling obligations that apply to clinical documentation workflows, including billing records.<\/p>\n                        <\/div>\n                                                <\/div>\n        <\/div>\n    \n\n\n<h2 class=\"wp-block-heading\">Frequently asked questions<\/h2>\n\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1785234768311\"><h3 class=\"schema-faq-question\">What is CPT Code 00546?<\/h3> <p class=\"schema-faq-answer\">CPT Code 00546 is the anesthesia code for thoracotomy procedures that combine pulmonary resection with thoracoplasty. It carries 15 base anesthesia units and sits in the 00540-00548 thoracotomy sub-group maintained by the American Medical Association.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234768312\"><h3 class=\"schema-faq-question\">How many base units does CPT 00546 have?<\/h3> <p class=\"schema-faq-answer\">CPT 00546 has 15 anesthesia base units. This is higher than the 12 base units assigned to CPT 00540. That code is the standalone option used for thoracotomy procedures that do not fit any of the more specific codes in the 00540-00548 sub-group.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234768313\"><h3 class=\"schema-faq-question\">What is the difference between CPT 00540 and CPT 00546?<\/h3> <p class=\"schema-faq-answer\">CPT 00540 and CPT 00546 are both standalone codes in the same thoracotomy sub-group, not a parent code and a variant. CPT 00540 covers thoracotomy procedures that do not fit a more specific code, with 12 base units. CPT 00546 applies specifically when the operative record documents pulmonary resection performed together with thoracoplasty, with 15 base units.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234768314\"><h3 class=\"schema-faq-question\">What modifiers apply to CPT Code 00546?<\/h3> <p class=\"schema-faq-answer\">The applicable modifiers are AA (anesthesiologist personally performs), QK (medically directs two to four CRNAs), and QX (CRNA under medical direction). QY (anesthesiologist medically directs one CRNA) and QZ (CRNA without medical direction) round out the list. Modifier selection must reflect the actual care arrangement to avoid False Claims Act exposure.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234768315\"><h3 class=\"schema-faq-question\">How is anesthesia reimbursement calculated for CPT 00546?<\/h3> <p class=\"schema-faq-answer\">Reimbursement equals (base units + time units + qualifying circumstance units) multiplied by the Medicare locality-specific conversion factor. For CPT 00546 with 15 base units and a 120-minute procedure (8 time units), the total is 23 units multiplied by the applicable conversion factor. Time units are typically calculated as one unit per 15 minutes, though individual payer contracts may vary.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1785234768316\"><h3 class=\"schema-faq-question\">Can a CRNA bill CPT 00546 independently?<\/h3> <p class=\"schema-faq-answer\">Yes. In states that have opted out of the Medicare physician supervision requirement, a CRNA can bill CPT 00546 independently using modifier QZ. That earns 100% of the Medicare allowed amount. In non-opt-out states, the medical direction rules apply instead. The CRNA bills QX at 50% of the allowed amount, while the directing anesthesiologist bills QK simultaneously.<\/p> <\/div> <\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>CPT Code 00546 is the anesthesia code for thoracotomy procedures involving the lungs, pleura, diaphragm, and mediastinum. It applies when the surgeon performs pulmonary resection together with thoracoplasty, and it carries 15 base anesthesia units within the 00540-00548 thoracotomy and thoracoscopy sub-group. This reference guide covers the official descriptor, base unit value, and applicable modifiers. [&hellip;]<\/p>\n","protected":false},"author":81,"featured_media":168465,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_yoast_wpseo_linkdex":"","_yoast_wpseo_content_score":"","_yoast_wpseo_is_cornerstone":"","_yoast_wpseo_keywordsynonyms":"","_yoast_wpseo_focuskw_text_input":"","_seo_original_html":"","footnotes":""},"categories":[1433,1546],"tags":[4162,2387,1162,1602,4164],"class_list":["post-168468","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-billing-codes","category-cpt-codes","tag-anesthesia-billing","tag-claim-denials","tag-cpt-codes","tag-cpt-modifiers","tag-crna"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.2 (Yoast SEO v28.2) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>CPT Code 00546: Anesthesia for pulmonary resection with thoracoplasty<\/title>\n<meta name=\"description\" content=\"CPT Code 00546 covers anesthesia for pulmonary resection with thoracoplasty, billed at 15 base units with modifiers AA, QK, QX, QY, or QZ.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/\" \/>\n<meta property=\"og:locale\" content=\"nl_NL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"CPT Code 00546: Anesthesia for pulmonary resection with thoracoplasty\" \/>\n<meta property=\"og:description\" content=\"CPT Code 00546 covers anesthesia for pulmonary resection with thoracoplasty, billed at 15 base units with modifiers AA, QK, QX, QY, or QZ.\" \/>\n<meta property=\"og:url\" content=\"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/\" \/>\n<meta property=\"og:site_name\" content=\"Pabau\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/Pabau\/\" 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is an all-in-one healthcare practice management software platform designed for clinics, medspas, therapists, and medical professionals. 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He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.\",\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/blog\\\/author\\\/aleksandar-kochovski\\\/\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768311\",\"position\":1,\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768311\",\"name\":\"What is CPT Code 00546?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT Code 00546 is the anesthesia code for thoracotomy procedures that combine pulmonary resection with thoracoplasty. It carries 15 base anesthesia units and sits in the 00540-00548 thoracotomy sub-group maintained by the American Medical Association.\",\"inLanguage\":\"nl-NL\"},\"inLanguage\":\"nl-NL\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768312\",\"position\":2,\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768312\",\"name\":\"How many base units does CPT 00546 have?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 00546 has 15 anesthesia base units. This is higher than the 12 base units assigned to CPT 00540. That code is the standalone option used for thoracotomy procedures that do not fit any of the more specific codes in the 00540-00548 sub-group.\",\"inLanguage\":\"nl-NL\"},\"inLanguage\":\"nl-NL\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768313\",\"position\":3,\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768313\",\"name\":\"What is the difference between CPT 00540 and CPT 00546?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"CPT 00540 and CPT 00546 are both standalone codes in the same thoracotomy sub-group, not a parent code and a variant. CPT 00540 covers thoracotomy procedures that do not fit a more specific code, with 12 base units. CPT 00546 applies specifically when the operative record documents pulmonary resection performed together with thoracoplasty, with 15 base units.\",\"inLanguage\":\"nl-NL\"},\"inLanguage\":\"nl-NL\"},{\"@type\":\"Question\",\"@id\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768314\",\"position\":4,\"url\":\"https:\\\/\\\/pabau.com\\\/nl\\\/procedure-codes\\\/cpt-code-00546\\\/#faq-question-1785234768314\",\"name\":\"What modifiers apply to CPT Code 00546?\",\"answerCount\":1,\"acceptedAnswer\":{\"@type\":\"Answer\",\"text\":\"The applicable modifiers are AA (anesthesiologist personally performs), QK (medically directs two to four CRNAs), and QX (CRNA under medical direction). QY (anesthesiologist medically directs one CRNA) and QZ (CRNA without medical direction) round out the list. 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He specializes in topics around compliance in software solutions. When he's not writing at Pabau, you can find him tending to his bonsai collection or hitting the gym.","url":"https:\/\/pabau.com\/nl\/blog\/author\/aleksandar-kochovski\/"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768311","position":1,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768311","name":"What is CPT Code 00546?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT Code 00546 is the anesthesia code for thoracotomy procedures that combine pulmonary resection with thoracoplasty. It carries 15 base anesthesia units and sits in the 00540-00548 thoracotomy sub-group maintained by the American Medical Association.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768312","position":2,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768312","name":"How many base units does CPT 00546 have?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 00546 has 15 anesthesia base units. This is higher than the 12 base units assigned to CPT 00540. That code is the standalone option used for thoracotomy procedures that do not fit any of the more specific codes in the 00540-00548 sub-group.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768313","position":3,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768313","name":"What is the difference between CPT 00540 and CPT 00546?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"CPT 00540 and CPT 00546 are both standalone codes in the same thoracotomy sub-group, not a parent code and a variant. CPT 00540 covers thoracotomy procedures that do not fit a more specific code, with 12 base units. CPT 00546 applies specifically when the operative record documents pulmonary resection performed together with thoracoplasty, with 15 base units.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768314","position":4,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768314","name":"What modifiers apply to CPT Code 00546?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"The applicable modifiers are AA (anesthesiologist personally performs), QK (medically directs two to four CRNAs), and QX (CRNA under medical direction). QY (anesthesiologist medically directs one CRNA) and QZ (CRNA without medical direction) round out the list. Modifier selection must reflect the actual care arrangement to avoid False Claims Act exposure.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768315","position":5,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768315","name":"How is anesthesia reimbursement calculated for CPT 00546?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Reimbursement equals (base units + time units + qualifying circumstance units) multiplied by the Medicare locality-specific conversion factor. For CPT 00546 with 15 base units and a 120-minute procedure (8 time units), the total is 23 units multiplied by the applicable conversion factor. Time units are typically calculated as one unit per 15 minutes, though individual payer contracts may vary.","inLanguage":"nl-NL"},"inLanguage":"nl-NL"},{"@type":"Question","@id":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768316","position":6,"url":"https:\/\/pabau.com\/nl\/procedure-codes\/cpt-code-00546\/#faq-question-1785234768316","name":"Can a CRNA bill CPT 00546 independently?","answerCount":1,"acceptedAnswer":{"@type":"Answer","text":"Yes. In states that have opted out of the Medicare physician supervision requirement, a CRNA can bill CPT 00546 independently using modifier QZ. That earns 100% of the Medicare allowed amount. In non-opt-out states, the medical direction rules apply instead. 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