Sunday, May 8, 2016

How much payment would be reimbursed when modifer AA. AD, QK, QK used?

Modifier Description % of Allowed Charge

AA Anesthesia services performed personally by the anesthesiologist 100 percent
AD Medical supervision by a physician; more than four concurrent anesthesia procedures. (Three base units + actual time units allowed) 65 percent
QK Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals). 65 percent
QY Medical direction of one CRNA/AA by an anesthesiologist 65 percent
QX CRNA/AA service with medical direction by an anesthesiologist. 35 percent
QZ CRNA service without medical direction by an anesthesiologist. 70 percent

Note: Modifiers are also required for add-on codes 01953, and 01968-01969

Physical Status Modifiers

Physical status modifiers distinguish between various levels of complexity of the anesthesia service provided based on the patient’s condition and are represented by the letter P followed by a single digit. These modifiers are required for Modified Anesthesia Care (MAC).

P1 Normal healthy patient
P2 Patient with mild systemic disease
P3 Patient with severe systemic disease
P4 Patient with severe systemic disease that is a constant threat to life
P5 Moribund patient who is not expected to survive without the operation
P6 Declared brain-dead patient whose organs are being removed for donor purposes

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