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Thread: anesthesia physical status modifiers...

  1. #1
    Join Date
    Apr 2007
    orange, ca

    Default anesthesia physical status modifiers...

    AAPC: Back to School

    I am new to anesthesia coding and was wondering if anyone has any links or info on examples of dx that support the physical status modifiers of P3 or greater?
    for example, dx: 496, 414.0, 428.0, 250.00, 278.01, 427.31.....

    thx for all your help/assistance!

  2. #2

    Default Info I have found

    P1 — Normal fit patient •
    P2 — Patient with slight systemic disease •
    P3 — Patient with moderate systemic disease which can be life threatening •
    Stable angina. This patient has a systematic disease that could kill him, however he is stable and expected to fare well
    P4 — Patient with severe systemic disease that's a constant threat to life •
    patients who aren't expected to die in the perioperative period, although it would not be totally unexpected if they do," Someone with angina, or in congestive heart failure who needs surgery, would be a 4

    P5 — Moribund patient who is not expected to stay alive with or without the operation •

    P6 — Declared brain-dead patient whose organs are being removed for donor purposes.

    The ASA doesn't provide solid definitions for physical status modifiers as their use is based on clinical decisions the anesthesia provider makes for each patient. Hint: Most of your anesthesiologist's services call for a P1, P2, or P3 modifier. To utilize P$ or higher, you require clear documentation in the medical record to support its use. Even if your anesthesiologist categorizes a patient as P3, many payers will require more information to support the claim

  3. #3
    Join Date
    Apr 2007
    Lebanon, New Hampshire


    Not sure where you are in the US, but I think you can go into my local Medicare contractor's site and look at the Anesthesia Billing Guide (http://www.medicarenhic.com/ne_prov/publications.shtml). It will have everything you need to know. You might want to check your local carrier's website to see if they have the same thing.

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