Anesthesia Billing & Coding Explained

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.

How To Use Modifiers For Anesthesia Billing?

Anesthesia modifiers must be used with anesthesia procedure codes to indicate whether the procedure was personally performed, medically directed, or medically supervised.

• Modifier AA: Anesthesia services personally performed by the anesthesiologist
• Modifier AD: Medical supervision by a physician; more than four concurrent anesthesia services.
• Modifier G8:  Monitored anesthesia care (an informational modifier, does not affect reimbursement).
• Modifier G9: MAC for at risk patient (an informational modifier, does not affect reimbursement).
• Modifier QK: Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals.
• Modifier QS: Monitored anesthesia care (an informational modifier, does not affect reimbursement).
• Modifier QX: CRNA service with medical direction by a physician.
• Modifier QY: Medical direction of one CRNA by a physician.
• Modifier QZ: 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.