Thursday, July 28, 2016

Anesthesia incorrect modifier usage

Anesthesia Modifiers *not an all-inclusive list. 


Modifiers must be billed with anesthesia procedure codes to indicate whether the procedure was personally performed, medically directed or medically supervised.

Service will deny: 

· When billed without appropriate modifier for provider’s specialty
· When modifier is not billed in the appropriate modifier position.
· When billed with invalid modifier combinations. (see incorrect modifier billing combination grid below)
· If not billed in accordance with standard coding/billing guidelines and Neighborhood’s policies

Incorrect Billing Modifiers

Modifier                         Do Not file on the same claim line with:
AA – Anesthesiologists     AD, QY, QK, QX, or QZ
QY – Anesthesiologists    AA, AD, QK, QX, or QZ
QK – Anesthesiologists    AA, AD, QY, QX, or QZ
AD – Anesthesiologists    AA, QY, QK, QX, or QZ
QX – CRNAs                   AA, AD, QY, QK, or QZ
QZ – CRNAs                   AA, AD, QY, QK, or QX

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