Anesthesia Coding Alert

Look before you leap into using these tricky modifiersWhen an anesthesia case involving incomplete medical direction arrives on your desk, some coders might consider creating a claim in the CRNA's name and appended modifier QZ (CRNA service: without medical direction by a physician).Before taking that route, keep three tips in mind.1. Start With Your Local CarrierCMS does not have a national-level policy for incomplete medical direction. "Instead, CMS has directed the local carriers to address this issue case by case," says Cindy Hinton, CPC, CHCC, with Advanced Coding Solutions in Whitehouse, Tenn. "The final determination can vary, depending on the circumstances."But, in general, the CRNA could submit the claim by using modifier QZ, or the physician might report the procedure using modifier AD (Medical supervision by a physician: more than four concurrent anesthesia procedures).Caution: If the anesthesiologist reports modifier AD, the CRNA should report modifier QX (CRNA service: with medical [...]