# CRNA being denied a duplicate



## neecen (Sep 28, 2010)

I am billing for an Ohio Anesthetist the following: 
mod QY when the Anesthetist supervises one CRNA 
mod QK when the Anesthetist supervises two CRNA

I am getting denials from MMO, Anthem, Aetna, UHC and MCR sometimes on the CRNA stating it is a duplicate and sometimes they deny the anesthetist stating duplicate. Is there another modifier I should be using?


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## cmcgarry (Sep 28, 2010)

neecen said:


> I am billing for an Ohio Anesthetist the following:
> mod QY when the Anesthetist supervises one CRNA
> mod QX when the Anesthetist supervises two CRNA
> 
> I am getting denials from MMO, Anthem, Aetna, UHC and MCR sometimes on the CRNA stating it is a duplicate and sometimes they deny the anesthetist stating duplicate. Is there another modifier I should be using?



For the anesthesiologist (MD) use:
QY when supervising one CRNA procedure
QK when supervision two, three or four concurrent CRNA procedures

For the CRNA, use:
QX when supervised (medical direction) by a physician
QZ without medical direction by a physician.

If you are using QX on the anesthesiologist, that is incorrect.

Hope this helps,


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## neecen (Sep 28, 2010)

Lucinda, this is a big help. Thank you so much.


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## frankmmedbiller (Sep 30, 2010)

I am also being denied for dup i bill for 1 procedure and use qx qs for crna I am located in NY... I am also getting denials saying that the plans don't cover crna's and was told by a oxford rep to bill under the MD once with qyqs and again w/ qxqs can this be right? please help


cmcgarry said:


> For the anesthesiologist (MD) use:
> QY when supervising one CRNA procedure
> QK when supervision two, three or four concurrent CRNA procedures
> 
> ...


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## ohiocoder101 (Sep 30, 2010)

came across your post, was wanting to know, are you billing JUST for crna? or is your practice anesthesiologist/crna? 

if you are billing ONLY for crna, you would use qz only
if you are billing anesthesiologist/crna, you use qk/qx
if you are billing anesthesiologist/crna and its one to one ratio you bill qy/qx

if your group is crnas only, the md cannot bill anesthesia codes, they are there just for supervision only., ie-surgeron is overseeing crna.

hope this helps


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## frankmmedbiller (Oct 1, 2010)

Thank you for your help


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