Modifiers Questions: Coding Anesthesia for Two Separate Services but Same Day

[terhufen]

Hello, My question concerns acceptable modifiers for anesthesia for two separate surgeries but they are on the same day. We say append the 59 modifier only on the second surgery. Others are saying you can use modifier 76, 77, 78, and 79. My research shows that these are for CPT coding not ASA codes for anesthesia. Please advise. Thank you.

 

[LisaAlonso23]

Depending on the scenario, 59 is used for anesthesia providers.

 

[enancy79]

Which CPT codes are you billing. Some require modifiers for the 2nd procedure, but a few are excluded from that.

 

[jkyles@decisionhealth.com]

Hi there, I couldn't tell if this is for two surgeries performed during the same anesthesia session or two entirely different surgeries. At any rate, this excerpt from UHC's policy should help


Multiple Anesthesia Services:
According to the ASA, when multiple surgical procedures are performed during a single anesthesia administration, only the single anesthesia code with the highest Base Unit Value is reported. The time reported is the combined total for all procedures performed on the same patient on the same date of service by the same or different physician or other qualified health care professional. Add-on anesthesia codes (01953, 01968 and 01969) are exceptions to this and are addressed in the Anesthesia Services section and Obstetric Anesthesia Services section of this policy.UnitedHealthcare aligns with these ASA coding guidelines. Specific reimbursement percentages are based on the anesthesia modifier(s) reported.

Duplicate Anesthesia Services:
When duplicate (same) anesthesia codes are reported by the same or different physician or other qualified health care professional for the same patient on the same date of service, UnitedHealthcare will only reimburse the first submission of that code. However, anesthesia administration services can be rendered simultaneously by an MD and a CRNA during the same operative session, each receiving 50% of the Allowed Amount (as indicated in the Modifier Table above) by reporting modifiers QK or QY and QX.

In the event an anesthesia administration service is provided during a different operative session on the same day as a previous operative session, UnitedHealthcare will reimburse one additional anesthesia administration appended with modifier 59, 76, 77, 78, 79 or XE. As with the initial anesthesia administration, only the single anesthesia code with the highest Base Unit Valueshould be reported.