Anesthesia Billing Guidelines For CRNA’s

When filing claims through the Medicare program and the CRNA is employed by the anesthesiologists, reimbursement for “medically directed” by an anesthesiologist and “non-medically directed” are revenue neutral – meaning reimbursement is equal to the same amount.  For example, when medical direction modifiers “QK and QX” are reported (see table below), reimbursement is divided equally…

Certified Registered Nurse Anesthetist Billing Explained

Anesthesia Billing for CRNAs A timely topic if ever there was one!  This issue continues to be a source of confusion to physician offices, billers, hospitals, and insurance companies, too. A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice nurse who is an anesthesia specialist and may administer anesthesia independently or under physician “medical…

List With Anesthesia CPT Codes That Require Authorization

Anesthesiologists are NOT required to request prior authorization. The surgeon must obtain prior authorization when required for procedures identified in the Medical and Surgical Procedure Code List included with the Utah MedicaidProvider Manual for Physician Services.The anesthesiologist is required to enter the prior authorization number obtained by the surgeon for the CPT code when billing…

Modifier QK, QX, QY, QZ, QS, G8 & G9 For Anesthesia Billing

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 –…