Anesthesia Coding Alert

Establish guidelines to help your medical direction claims."Physically present and available" can be one of the trickiest factors to determine when confirming medical direction. Keep these guides in mind when deciding whether your anesthesiologist's claim still merits medical direction modifiers 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). Consider Individual CircumstancesVague medical direction rules -- such as "remains physically present and available for immediate diagnosis and treatment of emergencies" " allow for individual interpretation. "This is similar to E/M 'incident to' criteria for service in the office," says Catherine Brink, BS, CMM, CPC, CMSCS, president of Healthcare Resource Management, Inc., in Spring Lake, N.J. "The supervising physician for 'incident to' billing must be physically present in the office suite -- but there's a lot of interpretation of 'suite.'"Accurately defining "immediately available" is [...]