Find Split Billing Payment Answers
Question: Can an AA (anesthesia assistant) bill with a QZ modifier? Does this mean all AAs have to be supervised? Also, we are going to change our split billing from 50-50 to 60-40. Medicare does not require that you bill 50-50, do they? I find nowhere in the manual that you have to bill 50-50, only payment information on split billed claims. Texas Subscriber Answer: Unfortunately, it becomes confusing when reputable resources continue to list modifier QZ (Certified registered nurse anesthetist (CRNA) without medical direction by a physician) as applicable to anesthesia assistants (AAs), as is the case on the Centers for Medicare & Medicaid Services (CMS) website. However, AAs do not qualify for QZ modifiers, as the modifier definition includes the term certified registered nurse anesthetists (CRNAs). AAs are required to work under the medical direction of an anesthesiologist. Regarding your billing, Medicare does not dictate how much of the charge is applied to either the physician or the qualified nonphysician anesthetist, although the payment to each is 50 percent of the allowed amount for medically directed services. Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPMA, CPC, CPC-I, Perfect Office Solutions
