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Thread: TX Medicaid Anes Modifiers

  1. #1

    Lightbulb TX Medicaid Anes Modifiers

    AAPC: Back to School
    Which of the Texas Medicaid managed care entities require the U1 modifier to designate a single anesthesia claim will be submitted? We've been told Texas Medicaid and TMHP Superior Health, are there others?

  2. #2
    Join Date
    Apr 2007
    Coastal Coders


    As it applies to what?
    C-sections and Labor Inductions?
    The way I understand it is that it will apply to all of them.
    U1 = medically necessary prior to 39 wks
    U2 = 39 wks or later
    U3 = non-medically necessary prior to 39 wks
    Effective 09.01.11

    If you hear any different please let me know.

  3. #3

    Default Texas Anesthesia Modifiers

    This is the definition for Anesthesia use of the U1 modifier: Modifiers U1 (indicating one Medicaid claim) and U2 (indicating two Medicaid claims, one by the supervising anesthesiologist and one by the CRNA) are state-defined modifiers that must be billed by an anesthesiologist or CRNA.

    Are other medicaid managed care entities in Texas using this to process anesthesia claims?

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