Propyphol

LORA CRAWFORD

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Hi, Still working on getting our ASC open. I was told that 1X a month we will be doing colonoscopies with propyphol (general anesthesia). Would I code this with a modifier 23? Thank you for your help. Lora
 
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23 would not apply since it is not unusual; however beware of payors. Medical necessity must be well documented or the ASA will not be paid.
 

mbort

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Are you wanting to add the 23 modifier to the procedure code (ie 45378-23)? Are you wanting to bill for the medication??
 
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cconroycpch

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The colonoscopies will most likely be done under MAC (monitered anesthesia care) and would not use a modifier 23. Modifier 23 is used for physicians and not ASC facilities and MAC is not unusual for colonoscopies.
 

mbort

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cconroycpch is correct, I wasnt thinking that far in advance (long week and brain dead). The 23 modifier is NOT an ASC modifier therefore its not even a consideration in that setting.

thanks cconroycpch :)
 
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