Second request... Assisting anesthesiologist

How do you code for an assisting anesthesiologist? I have a case where the first anesthesiologist needed help with a super morbid obese patient for labor and delivery. Please help. Thank you

Assistant anesthesiologist

I've never heard of two anesthesiologists being paid for the same surgery. Does anyone else know?

Medicare

No, it could happen but is rare. This should be discussed with payer and medical necessity will be the issue. CAUTION

Two Anesthesia Providers

CMS' manual mentions the fact that two Anesthesia providers may both need to be involved in a case.

They say:

The physician and the CRNA (or AA) [can be] involved in one anesthesia case and the services of each are found to be medically necessary. Documentation must be submitted by both the CRNA and the physician to support payment of the full fee
for each of the two providers. The physician reports the “AA” modifier and the CRNA reports the “QZ” modifier for a nonmedically directed case.

I'm not sure why they didn't address the possibility of it being two MDs, but you would think that if they were ok with paying the full rate to an MD and CRNA, that they would also be ok with paying the full rate to two MDs. As has already been pointed out, establishing medical necessity by way of the documentation is key.

Seth Canterbury, CPC, ACS-EM