# QX or QZ



## Lisa Heikes (Dec 3, 2010)

If the CRNA is working independently except for the operating room physician which  modifier would we use?

Could someone claify the definition of QZ modifier  CRNA service: with medical direction by physician.  Does the physician mean an anesthesiologit (MD) or the operating physician.

THANKS


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## NaliniAAPC (Dec 3, 2010)

At my point understanding QZ and QX all are anesthesia modifiers, so they mentioning anesthesiologist only! 

Regards,
Nalini CPC


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## dwaldman (Dec 3, 2010)

http://www.cms.gov/manuals/downloads/clm104c12.pdf

Page 122

If you use QX, they are going to pay the CRNA 50% of allowable assuming that the Anesthesiologist would be medically direcrting and billing QY or QK to receive the other 50% of the allowable of total anesthesia payment.

If you bill QZ it would reimburse at 100% of the allowable.

NCCI policy guidelines prevents the surgeon performing the procedure to also report the anesthesia service for example MAC or general. So the surgeon would not be able report it in that sense and if you look at a couple of pages back from 122 it gives the criteria for meeting the requirements of  Medical direction.


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