Anesthesia Modifiers - 01380 - ED Physician

KMC0231

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Hello all,

I am at an absolute loss with this.
Our ED physician has tried billing 01380-QS and 01380-QZ-QS to Medicare.
Medicare has rejected both stating that the modifier(s) is inconsistent or invalid with the service.

After researching, I have found that the QS modifier is informational only and should be reported in the 2nd field, after the pricing modifier.
All pricing modifiers seem to only apply to A) Anesthesiologists 2) CRNA's

I understand that both of the formats used above are incorrect.
What I do not understand is how an ED doc should bill 01380.

Has anyone ever billed for anesthesia services for an ED doc before?
Could anyone advise on the correct modifiers to use?

I would greatly appreciate your help!

Thank You,
Lost & New at this
 

CodingKing

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Only the anesthesiologist can bill those codes. The ER physician should be billing for the surgical procedure and mod 47 if er doc provided the regional or general anesthesia for the procedure they performed. It wont pay any extra.
 

KMC0231

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Burlington, NJ
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Thank you so much!!!!

This would be across the board (meaning all payers), correct?

Have a great day!!!
 
Last edited:

CodingKing

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Correct the ASA anesthesia codes (the ones that begin with a 0) are meant for the Anesthesiologist for all payers.
 
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