Anesthesia modifier - where to report in CMS 1500 and electronic loop

Informational
(No additional payment for informational modifiers)
Modifier Description
G9 Monitored Anesthesia Care (MAC) for patient who has history of severe cardiopulmonary condition
P1 A normal healthy patient
P2 A patient with mild systemic disease
P3 A patient with severe systemic disease
P4 A patient with severe systemic disease that is a constant threat to life
P5 A moribund patient who is not expected to survive without the operation
P6 A declared brain-dead patient whose organs are being removed for donor purposes

Modifiers should be entered in item 24d following the procedure code on the CMS-1500 claim form or electronic equivalent.


Electronic:
Loop 2400/SV101-1 (HC) Service ID Qualifier
Loop 2400/SV101-2 Procedure Code
Loop 2400/SV101-3 Procedure Modifier 1
Loop 2400/SV101-4 Procedure Modifier 2
Loop 2400/SV101-5 Procedure Modifier 3
Loop 2400/SV101-6 Procedure Modifier 4