Modifiers

All anesthesia claims require a modifier.  Failure to use the applicable modifier will result in the claim being returned to the provider for correction.      Modifier P1 must be billed with the appropriate five-digit CPT-4 anesthesia code to identify a normal, uncomplicated anesthesia provided by a physician.     Modifier ZE must be billed with the ... Read More

ANESTHESIA MODIFIERS- Utah Medicaid Report all anesthesia with the anesthesia five-digit procedure code (00100 through 01999) plus the addition of a physical status modifier. The use of other optional modifiers may be appropriate. Physical Status Modifiers Physical Status modifiers are represented by the initial letter “P” followed by a single digit from “1 to 6″. ... Read More

Anesthesia Modifiers 1. Physical Status Modifiers. Physical status modifying units will be reimbursed if the patient is ranked in one of the following three categories. Physical status is included in CPT to distinguish various levels of complexity of the anesthesia service provided. Example: 00100-P3 Status Modifiers    Description                                        Modifying Unit Value P3                      A patient with severe ... Read More

Add the appropriate Level 1 CPT modifier or HCPCS Level II modifier to the five digit code or identify the modifier by use of a separate code by adding 099 before the 2 digit number e.g. 09950, 09951. Level 1 CPT Modifier                 Description -23 Unusual Anesthesia               Occasionally, a procedure, which usually requires either no anesthesia ... Read More

Billing Modifiers The following modifiers are used when billing for anesthesia services: • QX – Qualified nonphysician anesthetist with medical direction by a physician. • QZ – CRNA without medical direction by a physician. • QS – Monitored anesthesiology care services (can be billed by a qualified nonphysician anesthetist or a physician). • QY – ... Read More