Modifier Coding Alert

Answer: The key to determining the modifier for these two codes is whether your physician was supervising or directing the one certified registered nurse anesthetist (CRNA). 

 

Medically directed anesthesia services are services performed by a CRNA or anesthesiology assistant (AA) and directed by an anesthesiologist who performs the pre-anesthesia exam and evaluation, prescribed the anesthesia plan, participates in the procedures, monitors frequently, remains physically present, and indicates post-anesthesia care.

 

Medically supervised anesthesia services are performed by a CRNA and is supervised by the attending physician who is responsible for reviewing and verifying the pre-anesthesia exam and evaluation, the anesthesia plan, and reviews and comments during the pre- and post-anesthesia care. 

 

If your physician was supervising the CRNA, you’ll need modifier AD (Medical supervision by a physician: more than four concurrent anesthesia procedures). 

 

If she was directing one CRNA, you would instead report the following codes: