Wednesday, June 2, 2010

CPT and HCPCS Modifiers for Anesthesia Services.

Add the appropriate Level 1 CPT modifier or HCPCS Level II modifier to the five digit code or identify the modifier by use of a separate code by adding 099 before the 2 digit number e.g. 09950, 09951.

Level 1 CPT Modifier                 Description

-23 Unusual Anesthesia               Occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual circumstances must be done under general anesthesia. This circumstance may be reported by adding the modifier ‘-23’ to the procedure code of the basic service or by use of the separate five digit modifier code 09923.

-47Anesthesia by Surgeon                Regional or general anesthesia provided by the surgeon may be reported by adding the modifier ‘-47’ to the basic service or by use of the separate five digit modifier code 09947. (This does not include local anesthesia.) Note: Modifier ‘–47’ or 09947 would not be used as a modifier for the anesthesia procedures 00100-01999.

-51 Multiple Procedures                 This modifier must be used to report multiple procedures performed at the same session. The service code for the major procedure or service must be reported without a modifier. The secondary, additional or lesser procedure(s) must be identified by adding the modifier ‘51’ to the end of the service code for the secondary procedure(s). Note: This modifier should not be used with designated “add-on” codes or with codes in which the narrative begins with “each additional.” (See Appendix B)

-QK Medical Direction of Multiple Anesthesia Procedures            This modifier must be used in conjunction with the appropriate service code to denote medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals.

-QX CRNA Service                     This modifier must be used to report services of a CRNA: with medical direction by a physician. This medical direction modifier is used when the physician medically directs two, three, or four concurrent procedures involving interns, residents, CRNAs and AAs. This allows 50% of the fee to be paid to the employer.

-QY CRNA Service                      This modifier must be used to report services of one CRNA: with medical direction by an anesthesiologist. This allows 100% of the fee to be paid to the employer.

-QZ CRNA Service                         This modifier is used to report CRNA service: without medical direction by a physician. This allows 100% of the fee to be paid to the employer.

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