Anesthesia Coding Alert

Payer policies dictate when MAC modifiers apply. Even if your anesthesia provider marks "MAC" (monitored anesthesia care) on a patient's chart, read through the anesthesia record and check with the physician or CRNA before making coding assumptions. Here's why: If the patient was unable to respond purposefully and did lose consciousness during the procedure, the case qualifies as general anesthesia -- which means MAC coding doesn't apply. Verify your provider's service to ensure you correctly report the care. Know the Circumstances That Merit Modifiers When you do report MAC, check whether the payer requires you to append special modifiers for Medicare patients. HCPCS includes three options: G8 -- Monitored anesthesia care (MAC) for deep, complex, complicated, or markedly invasive surgical procedure G9 -- Monitored anesthesia care (MAC) for patient who has history of severe cardiopulmonary condition QS -- Monitored anesthesia care service. If your carrier requires MAC modifiers, append modifier QS to the claim [...]