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New to Anesthesia have a couple questions

  1. #1
    Default New to Anesthesia have a couple questions
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    Question 1) I found a few articles that say P1 to P5 modifiers are not recognized by Medicare. Is this true? is there a CMS article to back this up?

    Question 2) This practice is doing Anesthesia billing for Gastro only, when a patient comes in for a colonoscopy or EGD is it necessary to code all non procedure related dx codes for example: Diabetes, Hypertension, Obesity

    I don't think these should be added as they have nothing to do with the procedure performed.

  2. #2
    True, Medicare does not recognize the P1 to P5 modifiers.

    As for the additional dx codes, this could be a requirement by the payor or LCD for instance depending on the type of anesthesia technique, a secondary dx needs to be indicated to support the technique.

    Hope this helps.
    Last edited by lmathews; 10-25-2018 at 06:35 AM.

  3. #3
    I agree with this.

    Include the physical status qualifying diagnoses even when you cannot capture the physical status P1-P5 modifiers, i.e. Medicare.

    Just to clarify on a point, you need to prove why the patient needed this level of anesthesia care vs. moderate sedation.

    ~Melissa, CPC

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