# CRNA modifier question



## nikmpayne (May 3, 2016)

Please help clarify modifiers QX versus QZ to us newbies at anesthesia billing. Our provider has a CRNA staffing company who provides the anesthesia while doctor performs procedure.  Would this scenerio fall under QX:with medical direction when billing for the CRNA?

Thanks in advance.


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## Nreed (May 3, 2016)

The CRNA modifiers are QZ which is used when the CRNA is performing anesthesia services without medical direction.
The QX is when the CRNA is being medically directed by an Anesthesiologist

When you say the doctor is performing the procedure, I'm assuming you are meaning the surgeon, and the CRNA is providing the anesthesia service.  

If he/she is not being medically directed by an anesthesiologist, then you will submit his/her charge with the QZ modifier.  

Medical direction occurs when an anesthesiologist is involved in one, two, three or four concurrent procedures where the anesthesiologist is physically present.  If that's the case, the MD will report their modifier QK or QY along with the CRNA QX.

I hope that helps


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## nikmpayne (May 3, 2016)

Yes, Thank you!!!! very helpful.


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## dpopik@verizon.net (Dec 6, 2016)

*Anesthesia CRNA question*

We are having a little bit of an issue with our CRNA anesthesia coding and the modifiers.  If you're billing under the doctor and using a CRNA, do you "have" to use the modifiers?  We would have to use QZ if that's the case.  I'm just curious, because all insurance companies requests are different it seems like.


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