Wiki Help with anesthesia modifiers!


North Liberty, IA
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Hi, i'm new to anesthesia billing and I need some help! What in the chart documentation do you use to determine which anesth modifier to use? (i.e. AA QY QK AD QX QZ, etc) Please help!

Descriptions of these modifiers are in the HCPCS book. Depending on the scope of the anesthesia practice, number of cases the provider is or isn't directing, documentation and state licensing requirements you could be billing any of these modifiers.
If an MDA is personally performing = AA modifier
CRNA is personally performing = QZ modifier
The other modifiers are medical direction and supervision modifiers that would be billed instead of the AA and QZ modifiers.

Julie, CPC
Last edited:
Look at the anesthesia record. The op report will be of no assistance in determining personally performed or medically directed anesthesia. Do you have both MD Anesthesiologists (MDA) and CRNAs in your practice?

Below is the CMS manual link. See page 115 which outlines Anesthesia services billing specifications and modifier definition.

Julie, CPC
Last edited:
anesthesia code

Hi...what modifier should be used for anesthesologist who performed iv sedation in a dental office. I need anyone's help.