Anesthesia – A process of Medication being administered to a patient to perform Medical procedures
without any pain. The patient is unconscious, oblivious to any pain and discomfort including
emotional stress at the time of the Medical procedure.
Anesthesia billing, on the other hand, is distinctive and unparalleled when compared to other
medical specialty billing.
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Anesthesia Billing and Coding Services
QS Modifier:
The usage of Modifiers such as the QS modifier informs the insurances (Commercial and Federal) that
Monitored Anesthesia care service was provided. This modifier should be appended for Anesthesia
procedure codes alone. The time duration of the procedure should be included on the claim as well.
This modifier should be in the second modifier slot on the claim form; this modifier would be
followed by the documentation modifier.
AA Modifier:
This AA Modifier is used on claims when billing to all insurance when the Anesthesia service was
performed personally by the Anesthesiologist. The billing of this modifier renders reimbursement at
100%.
QY/QK Modifier:
The usage of the QY modifier when billed on a claim denotes that the Anesthesiologist Medically
directed 1 CRNA; billing of this modifier would result in a 50% reimbursement. The usage of the QK
Modifier is reported on the claim when the Anesthesiologist Medically directs 2-4 concurrent
Anesthesia procedures; billing of this modifier would result in a 50%
QX/QZ Modifier:
The QX modifier is used when billing for a CRNA Medically directed by an MDA. The QZ is used when a
CRNA administers Anesthesia without an MDA present. Reimbursement of the claims billed with the QX
modifier is reimbursed at a 50%. Claims billed with the QZ Modifier are reimbursed at a 100%.
AD Modifier:
This modifier is frequently being used on claims. This modifier is reported on a claim when the
Anesthesiologist Medically supervises more than 4 concurrent anesthesia procedures. When the
Anesthesiologist is not present at the time of induction the payment is made as (3 base units + time
units) x 50%. When the Anesthesiologist is present at the time of induction and when supporting
documentation is submitted an additional unit is paid. The payment is as follows (3 Base + time
units + 1 time unit for induction) x 50%.
Not reporting of the appropriate modifiers would result in the lowest allowed percentage.
Anesthesia pricing modifiers always will be listed first in order to ensure timely and accurate
reimbursements.
• AA: Anesthesia services that’s performed by an Anesthesiologist personally. This modifier allows
full reimbursement.
• AD: Services by an Anesthesiologist under medical supervision for more than 4 simultaneous
procedures.
• QK: Medical direction by physician for 2,3 or 4 concurrent anesthesia procedures that has involved
qualified individuals or experts.
• This modifier limits 50% of the payment amount that have been allowed if performed by
anesthesiologist personally or by CRNA.
• QX: CRNA services by anesthesiologist with medical direction.
• This modifier limits 50% of the payments that would have been allowed if performed by
anesthesiologist personally or by non supervised CRNA.
• QY:Anesthesiologist medically directs one CRNA.
• This modifier limits 50% of payments to anesthesiologist as well as CRNA that would have been
personally performed by anesthesiologist.
• QZ: CRNA services without any medical direction by anesthesiologist.
• This modifier has no limits and no effect on payments and allowed amount is what anesthesiologist
would have performed personally.
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