I am payor and I just came across a bizarre case. I have an anesthesiologist bill for a surgery procedure code with modifier AA. Now my question is, can they do this? I am under the impression that if they are doing anesthesia services then they need to bill with the proper anesthesia code.
-
If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below..
Wiki surgery code with AA modifier
- Thread starter saramey79
- Start date
We bill anesthesia and we've found that some payers want the surgical CPT code with the anesthesia modifiers and some want the anesthesia CPT code with the anesth. modifier- so- they may not have known which way your business wanted it?
gost
Guru
I don't think there is a standard. I've known of at least 4 different billing requirements by various payers. Some want the surgical code. Some want the anesthesia code. Some want both. Some want the anesthesia code only if the code has only 1 possible unit value but both if there are multiple possible values. If you're lucky enough to have billing software that will accomodate each payer's requirements you don't, as a coder, have to worry about it too much.
In my mind, the "correct" way is to use the anesthesia code but that's my mind. It's not always in good working order.
In my mind, the "correct" way is to use the anesthesia code but that's my mind. It's not always in good working order.