Important Coding updates for Anesthesia

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Effective from 04/06/2017, If services billed with any combination of two or more of the following anesthesia modifiers on the same claim line, then it will not be eligible for reimbursement:

  • AA – Anesthesia services performed personally by an anesthesiologist
  • AD – Medical supervision by a physician of more than four concurrent anesthesia procedures
  • QK – Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals
  • QX – Qualified non-physician anesthetist with medical direction by a physician
  • QY – Medical direction of one qualified non-physician anesthetist by an anesthesiologist
  • QZ – Certified registered nurse anesthetist (CRNA) without medical direction by a physician

Impacted products

  • Select self-funded products
  • Commercially fully insured products
  • Medicare Advantage HMO products
  • Medicare Advantage PFFS products
  • Medicare Advantage PPO products
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