# Anesthesia Modifier Order?



## amzahorik (Mar 24, 2011)

Is there a specific order that the multiple modifiers have to appear on a anesthesia code.  I had listed 00920-Qx-QS-P1 on my practice test but it came back saying it was wrong and that it had to be 00920-QS-QX-P1.  Can someone point me in the right direction?


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## missyah20 (Mar 24, 2011)

I found this on the WPS Medicare website:

Anesthesia Documentation Modifiers
Documentation Modifiers direct prompt and correct payment of the anesthesia claims submitted. Documentation modifiers (AA, QK, AD, QY, QX and QZ) must be billed in the first modifier field. If a QS modifier applies, it must be in the second modifier field. Processing delays and denials may occur for claims submitted without the modifiers in the correct position.

Anesthesia documentation modifiers that MUST be billed in the first position:

AA –Anesthesia services performed personally by an anesthesiologist.

QK -Medical direction by a physician of two, three, or four concurrent anesthesia procedures.

AD -Medically supervised by a physician, more than four concurrent anesthesia procedures.

QY -Medical direction of one CRNA/AA (Anesthesiologist's Assistant) by an anesthesiologist.

QX -CRNA/AA (Anesthesiologist's Assistant) service with medical direction by a physician.

QZ -CRNA/AA (Anesthesiologist's Assistant) service without medical direction by a physician.

Here is the link if you want that as well:  http://www.wpsmedicare.com/j5macpartb/resources/modifiers/anesthesiamodifiers.shtml


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## dwaldman (Mar 28, 2011)

QX, QY, QK, AA ----these modifiers see more like pricing modifiers

QS seems like a informational modiifer

I would put the modifiers that determines the pricing of the ticket first.


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