# Anesthesia Billing with CRNA



## jscheetz (Dec 16, 2011)

Fact #1:  The following are modifiers that Medicare require to be used for the billing of anesthesia services:
AA:  Anesthesia services by a physician; more than four concurrent anesthesia procedures
AD:  Medical supervision by a physician:  more than four concurrent anesthesia procedures
QK:  Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals
QS:  Monitored anesthesia care service 
QX:  CRNA service; with medical direction by a physician
QZ:  CRNA service; without medical direction by a physician

Fact #2:  Patient had anesthesia performed by a CRNA.  CRNA's name was on the anesthesia report as providing anesthesia as well as post op sign off.

Fact #3:  Claim was submitted to insurance with an AA modifier and the anesthesiologists name as the rendering provider.

Question:  Was this claim billed correctly?

Thanks in advance for your help!


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## CVelez (Dec 16, 2011)

No.

AA = Anesthesia services performed personally by anesthesiologist.   

The claim should be filed under the name of the CRNA with the appropriate modifier.   

If the anesthesiologist was present and provided medical direction or supervision than you would also file a claim under his name with appropriate modifer.  

Charla


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## jscheetz (Dec 16, 2011)

*Supervision definition*

Charla,
Thank you!  Can you point me in the direction (assuming it exists) of what Medicare defines as supervision requirements to bill as supervision and/or medical direction?


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## JudyW (Dec 16, 2011)

You should go to your Medicare carriers website  and put in Anesthesia billing and you should be able to obtain everything you need to bill the anesthesia services with the correct guidelines and modifiers.  Make sure to check you LCD edits for your services as well.  Hope this helps.


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## srinivas r sajja (Dec 19, 2011)

http://www.supercoder.com/articles/...ection-know-the-specifics-to-increase-pay-up/


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