# physicial status modifiers



## 574coding (Mar 6, 2014)

Hi,
We are having reimbursement issues with Blue Shield underpaying on anesthesia due to a flat rate with the 2013 policy.  We were not using the physical status modifiers and will start to do this.  We checked with BS and they said the order should be "P3, AA (OR)QZ, QS, but as you all know if I call back, I may get a different answer! 

I see some of the post here on the AAPC site that the physical modifier should be second or last.  

Does any one have any luck with payment with the physical status modifier being in the first spot?

Does Medicare and Medical not recognize the modifier in 2014?

Any other advice on this issue?

Thank you for you help with this.


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## karras (Mar 9, 2014)

Medicare and Medicaid do not recognize the P modifiers.  

We list the P modifier last..AA/P2 or QK/P2.

Remember when to check the ASA codes when billing out anesthetic for a child under the age of 1.  Sometimes the ASA code will include age.  

Kim


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## hgolfos (Mar 10, 2014)

I agree with karras, Medicare and Medicaid generally do not accept physical status mods.  Though for Medicaid, some states do allow it (Georgia for instance). Also, as far as BCBS goes, it depends where you are.  BCBS of Alabama recently stopped accepting physical status mods on everything except MAC procedures with specific ASA codes.  I would ask your Blue Shield rep to direct you to their anesthesia policy in writing.  Then you'll be sure you're getting an accurate answer.  And then, file the mods in whatever order they want them in.


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