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Anesthesia Billing with CRNA

  1. Default Anesthesia Billing with CRNA
    Exam Training Packages
    Fact #1: The following are modifiers that Medicare require to be used for the billing of anesthesia services:
    AA: Anesthesia services by a physician; more than four concurrent anesthesia procedures
    AD: Medical supervision by a physician: more than four concurrent anesthesia procedures
    QK: Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals
    QS: Monitored anesthesia care service
    QX: CRNA service; with medical direction by a physician
    QZ: CRNA service; without medical direction by a physician

    Fact #2: Patient had anesthesia performed by a CRNA. CRNA's name was on the anesthesia report as providing anesthesia as well as post op sign off.

    Fact #3: Claim was submitted to insurance with an AA modifier and the anesthesiologists name as the rendering provider.

    Question: Was this claim billed correctly?

    Thanks in advance for your help!

  2. #2

    AA = Anesthesia services performed personally by anesthesiologist.

    The claim should be filed under the name of the CRNA with the appropriate modifier.

    If the anesthesiologist was present and provided medical direction or supervision than you would also file a claim under his name with appropriate modifer.


  3. Default Supervision definition
    Thank you! Can you point me in the direction (assuming it exists) of what Medicare defines as supervision requirements to bill as supervision and/or medical direction?

  4. #4
    Virginia Beach Local Chapter
    You should go to your Medicare carriers website and put in Anesthesia billing and you should be able to obtain everything you need to bill the anesthesia services with the correct guidelines and modifiers. Make sure to check you LCD edits for your services as well. Hope this helps.

    Past AAPC-CA BOD 2010 - 2013 & 2015 - 2017

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