Forum - Questions & Answers

Jan 5th, 2016 - CJKNIGHT 1 

Anesthesia Billing

If CRNA is employed by an Anesthesia Group and is working without medical direction or the MD/Anesthesiologist did not meet the 7 step criteria can the CRNA claim be billed with the QZ modifier?

Jan 5th, 2016 - ladyt 10 

re: Anesthesia Billing

Very short answer - yes

Jan 5th, 2016 - CJKNIGHT 1 

re: Anesthesia Billing

So, if the MD/Anesthesiologist is in the OR but is not medically directing or supervising the CRNA but did preform pre-anesthetic exam and prescribed the anesthesia plan for the case can the CRNA still bill with the QZ modifier?

Jan 5th, 2016 - ladyt 10 

re: Anesthesia Billing

Based on information in the 2012 Optum Anesthesia Coding and Payment Guide: when an anesthesiologist and a CRNA share services in one case, and the services are found to medically necessary, documentation must be submitted by both to support payment of the full fee for each provider. The Dr. would append modifier AA to his/her claim. The CRNA would append QZ.

Hope this helps! Lisa



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