What are the anesthesia modifiers?

Modifiers are two-character indicators used to modify payment of a procedure code or otherwise identify the detail on a claim. Every anesthesia procedure billed to OWCP must include one of the following anesthesia modifiers: AA, QY, QK, AD, QX or QZ.

What is an AA modifier?

The AA modifier is used for all payers on claims when the anesthesiologist worked the case alone. The AA modifier is exclusive to anesthesia claims. Some others frequently used are: QY = Anesthesia worked with a CRNA. QX = CRNA worked with an anesthesiologist.

What is a P3 modifier?

Modifier P3 A patient with severe systemic disease.

What is the difference between modifier QX and QK?

QK – Medical direction by a physician of two, three, or four concurrent anesthesia procedures. QY – Medical direction of one CRNA/AA (Anesthesiologist's Assistant) by an anesthesiologist. QX – CRNA/AA (Anesthesiologist's Assistant) service with medical direction by a physician.

What is G9 modifier?

G9 – Monitored anesthesia care for a patient who has a history of severe cardiopulmonary condition. (This modifier may be used in lieu of modifier QS). GC – Performed by a resident under the direction of a teaching physician.

When to Use Anesthesia Modifier Coding

What does GC modifier stand for?

A GC Modifier is a modifier added to a CPT code for service(s) performed in part by a resident under the direction of a teaching physician (TP). When should the GC modifier be used? A GC Modifier is used when a resident, under the direction of a teaching physician, is involved in the management and care of a patient.

What is modifier 23 used for?

Modifier 23 is used only with general or monitored anesthesia codes (CPT codes 00100- 01999). Modifier 23 is added after the primary anesthesia modifier which identifies whether the service was personally performed, medically directed or medically supervised (Modifiers AA, AD, QK, QS, QX, QY or QZ).

What is the purpose of modifiers 73 and 74?

Modifiers -73 and -74 are used to indicate discontinued surgical and certain diagnostic procedures only. They are not used to indicate discontinued radiology procedures.

How do you use modifier 27?

Use modifier -27 for multiple outpatient hospital evaluation and management (E/M) encounters on the same date. Use this modifier when a patient receives multiple E/M services performed by the same or different physicians in multiple outpatient hospital settings (e.g., emergency department, clinic, etc.)

What is the 26 modifier?

Current Procedural Terminology (CPT®) modifier 26 represents the professional (provider) component of a global service or procedure and includes the provider work, associated overhead and professional liability insurance costs. This modifier corresponds to the human involvement in a given service or procedure.

What is anesthesia modifier QZ?

Modifier QZ, in contrast, is used when care is provided in several different ways, including when: a nurse is supervised by a physician anesthesiologist or another physician; a nurse works without supervision; or. a physician anesthesiologist provides high-level care with limited documentation.

What is TC modifier on CPT code?

Using modifier TC identifies the technical component. Used when billing both the professional and technical component of a procedure when the technical component was purchased from an outside entity. The provider would bill the professional on one line of service and the technical on a separate line.

Can modifier 53 be used on anesthesia codes?

CPT modifier 53 is not valid when used for elective cancellation of a procedure prior to anesthesia induction and/or surgical preparation in the operating suite.

What modifier is used for CRNA?

The physician would report using the “AA” modifier and the CRNA would use “QZ,” or the modifier for a nonmedically directed case. Documentation must be submitted by each provider to support payment of the full fee.

What are anesthesia codes?

CPT codes 00100-01860 specify “Anesthesia for” followed by a description of a surgical intervention. CPT codes 01916-01933 describe anesthesia for radiological procedures. Several CPT codes (01951-01999, excluding 01996) describe anesthesia services for burn excision/debridement, obstetrical, and other procedures.

What is a 79 modifier?

Modifier 79 is used to indicate that the service is an unrelated procedure that was performed by the same physician during a post-operative period. Modifier 79 is a pricing modifier and should be reported in the first position. A new post-operative period begins when the unrelated procedure is billed.

What is a 78 modifier?

Modifier 78 is used to report an unplanned return to the operating or procedure room, by the same physician, following an initial procedure for a related procedure during the post-operative period.

What is a 22 modifier?

modifier 22 is a representation by the provider that the treatment rendered on the date of. services was substantially greater than usually required. The use of modifier 22 does not. guarantee additional reimbursement.

What is a 21 modifier?

CPT Modifier 21 is used when the face-to-face service provided is prolonged or otherwise greater than usually required for the highest level of evaluation and management (E&M) service within a given category.

What is modifier 20 used for?

This modifier should be added to the appropriate CPT code to indicate that the services were rendered or provided by a nurse practitioner. This modifier should be added to the appropriate CPT code to indicate that the services were rendered or provided by a physician assistant.

What is a 54 modifier?

Modifier 54

When a physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding this modifier to the usual procedure code.

What does modifier GQ mean?

GQ – Via asynchronous telecommunications system (e.g., 99201-GQ) Use of the GQ modifier certifies an asynchronous telecommunications system was used, such as Store and Forward technologies, to transmit medical or behavioral health information to the provider at the “distant site.”

What is a 24 modifier?

Modifier 24 is defined as an unrelated evaluation and management service by the same physician or other qualified health care professional during a post-operative period. Medicare defines same physician as physicians in the same group practice who are of the same specialty.

What is a 25 modifier?

Modifier 25 is defined as a significant, separately identifiable evaluation and management (E/M) service by the same physician or other qualified health care professional on the same day of the procedure or other service.