Anesthesia billing Code Modifiers

Anesthesia Code Modifiers

AA	Anesthesia services personally performed by anesthesiologist - Distinct fee schedule amount. Affects payment.
AD	Medical supervision by a physician: More than 4 concurrent anesthesia procedures. - Distinct fee schedule amount. Affects payment.
QK	Medical direction of 2, 3 or 4 concurrent anesthesia procedures involving qualified individuals - 1999 services limits the payment to 50% of the amount that would have been allowed if personally performed by a physician or non-supervised CRNA.
QS	Monitored anesthesia care - No effect on payment. For informational purposes only. Must be used in conjunction with a pricing anesthesia modifier.
QX	CRNA service with medical direction by physician - Payment is limited to 50% of the amount that would have been allowed if personally performed by physician or non-supervised CRNA.
QY	Medical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist.
QZ	CRNA service without medical direction by a physician - No effect on payment. Payment is equal to the amount that would have been allowed if personally performed by a physician.
23	Unusual anesthesia - Occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual circumstances must be done under general anesthesia.  This circumstance may be reported by adding the modifier -23 to the procedure code of the basic service.  Coverage /payment will be determined on a "by-report" basis.
47	Anesthesia by surgeon - Used to report regional or general anesthesia provided by the surgeon (Not covered by Medicare).