Does it matter what position modifiers are submitted on an anesthesia claim?

Answer
Yes. Documentation modifiers must be submitted in the first position. The appropriate modifier from the list below must be submitted in the first position to indicate whether the service was personally performed, medically directed or medically supervised:

  • AA – Anesthesia services performed personally by an anesthesiologist
  • QK - Medical direction by a physician of two, three, or four concurrent anesthesia procedures
  • AD - Medically supervised by a physician, more than four concurrent anesthesia procedures
  • QY - Medical direction of one CRNA/AA (Anesthesiologist's Assistant) by an anesthesiologist
  • QX - CRNA/AA (Anesthesiologist's Assistant) service with medical direction by a physician
  • QZ - CRNA/AA (Anesthesiologist's Assistant) service without medical direction by a physician

If one of the following monitored anesthesia modifiers applies, it must be submitted as an additional modifier in the second position: 

  • QS - Monitored anesthesia care service
  • G8 - Monitored anesthesia care (MAC) for deep complex complicated, or markedly invasive surgical procedures
  • G9 - Monitored anesthesia care for patient who has a history of severe cardio-pulmonary condition

Processing delays and rejections may occur for claims submitted without the modifiers in the correct position.

Resource: CMS IOM Pub. 100-04, Chapter 12, Section 50 (PDF, 1.05 MB)

Contact Railroad Medicare

Email Railroad Medicare

Contact a specific Railroad Medicare department

Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

Click to Chat Now