Claims Documentation Requirements
Submit claims for anesthesia services on the CMS-1500 claim form or the electronic equivalent. Use specific CPT American Society of Anesthesiology (ASA) anesthesia codes or surgical codes with the appropriate anesthesia modifier. For authorized surgical services, MHCP prefers that anesthesia services are billed using surgical procedure codes with the appropriate anesthesia modifier.
Anesthesiologists and CRNAs must comply with MHCP requirements for billing sterilization procedures. Submit a Sterilization Consent Form, signed and dated by the recipient and the physician, with anesthesia claims for sterilization procedures.
Submit the exact number of minutes from the preparation of the patient for induction to the time when the anesthesiologist or the CRNA was no longer in personal attendance or continues to be required. Enter only the number of minutes in the units box. MHCP will calculate the base units
for each procedure.
To properly identify the exact nature of the service provided, use the following modifiers:
AA – Anesthesia services performed personally by anesthesiologist
AD – Medical supervision by a physician: more than four concurrent anesthesia procedures
QK – Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
QS – Monitored anesthesia care services
QX – CRNA service with medical direction by an anesthesiologist
QY – Anesthesiologist medically directs one CRNA
QZ – CRNA service without medical direction by an anesthesiologist