Remember Anesthesia Modifiers Are Only for Anesthesia Practitioners
Question: A certified registered nurse anesthetist (CRNA) administered anesthesia during a laparoscopy but was “supervised” by the gynecologist performing the procedure, instead of an anesthesiologist. Should I append modifier QZ when I report the CRNA’s services? Codify Subscriber Rationale: Modifier QZ (Crna service: without medical direction by a physician) would not be an appropriate choice in this situation because you are coding for anesthesia services and the gynecologist who’s also in the room is not an anesthesiologist. And even though modifier QX (Crna service: with medical direction by a physician) may sound promising, appending it may encourage the payer look for an accompanying claim with modifier QY (Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist) or QK (Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals) for the anesthesiologist’s services; this code wouldn’t be applicable to the gynecologist, even though the gynecologist is a physician. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
