Anesthesia Billing and coding

Billing Instructions
Claims must be submitted on the claim Form CMS-1500 or electronic media claim equivalent.
The following are specific to anesthesia claims submission:
• Item 24D – the appropriate anesthesia modifier must be reported• Item 24G – the actual anesthesia time, in minutes, must be reported.
Anesthesia modifiers must be used with anesthesia procedure codes to indicate whether the procedure was personally performed, medically directed, or medically supervised.
AA  – Anesthesia services personally performed by the anesthesiologistAD  – Medical supervision by a physician; more than four concurrent anesthesia servicesG8 –  Monitored anesthesia care (an informational modifier, does not affect reimbursement)G9 –  MAC for at risk patient (an informational modifier, does not affect reimbursement)QK –  Medical direction of two, three or four concurrent anesthesia procedures involving qualified individualsQS –  Monitored anesthesia care (an informational modifier, does not affect reimbursement)QX –  CRNA service with medical direction by a physicianQY –  Medical direction of one CRNA by a physicianQZ –  CRNA service without medical direction by a physician
NOTE: Medicare does not recognize Physical Status P modifiers.
NOTE : Modifier QS versus Modifiers G8 or G9 should be used for Monitored Anesthesia Care.

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