Anesthesia Coding Alert

Reader Questions:

Anesthesiologist With 2 Cases

Question: The anesthesiologist supervised with a CRNA in one surgery room, then left to perform a pre-op block that would be the next patient's primary anesthesia. He returned to supervising the first case. How should we report the anesthesiologist's time? North Dakota SubscriberAnswer: Several state carriers have published information making it clear that the anesthesiologist can place arterial lines or pre-op blocks for one patient while medically directing another patient's case. If the physician met medical direction criteria, report his time and service 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) as appropriate. Append modifier QX (CRNA service: with medical direction by a physician) to the CRNA's claim.Different angle: If the anesthesiologist had been the only provider with the first patient and left to administer the second patient's [...]
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