Physical Status codes

linstedtt

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Columbus, Ohio
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Physical Status codes?

I'm looking for the guidelines for the physical status codes to show to a doctor. We work for a group of anesthesiologists and CRNAs and we are told to bill the p3 and p4 a lot, and myself and the other biller feel that much of the time, those modifiers are inappropriate. We know what each modifier is, but we can't find anything stating when it is appropriate to use them, and what diagnoses are valid with them. Can anyone tell me where to find this? Thanks in advance!!
 
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Modesto, CA; Central Valley Chapter
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Physical status codes

The P-modifiers can be found in the Anesthesia Relative Value Guide, which I found has a lot of good information in it. You can also find them in the CPT book.

They are pretty straight forward, I think.

P3 can be used for diabetic patients; while I have seen P4 used for diabetic patients whose blood sugar was uncontrolled.

Hope this helps
Tina, CPC-I
 

coder911

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Portland
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I agree with codingangel. If you are billing for anesthesia, you will really appreciate getting the Anesthesia RV Guide book. It will clear up a lot of confusion on using the status modifiers.
 

mcpalmeter

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Nor will you find anything. If you go out to the website of the American Society of Anesthesiologists (http://www.asahq.org/Newsletters/2002/9_02/vent_0902.htm) you will see an article which addresses the inappropriate use of physical status modifiers as some mechanism for determining operative risk.

If you do a search on the ASA's website with "physical status" the first link that comes up lists the modifiers and their descriptions. There is also a very emphatic note under the list that states, "These definitions appear in each annual edition of the ASA Relative Value Guide. There is no additional information that will help you further define these categories."


Maryann Palmeter, CPC
 
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