# coding anesthesia for AA directing CRNA's



## jonie122 (Jun 4, 2008)

My question is that is it correct to use the QK and the QY modifier for
Medicare on the same procedure when there is a CRNA also billing?
(ie.)  The AA bills 00840 -QK,QY, GC and the
         CRNA bills  00840 -QX,GC  

I think that the QK modifier is indicating that the AA is overseeing 2 or more
cases and that the QY modifier is indicating that he is only overseeing 1 CRNA case at the same time. Too me it seems that the modifiers are conflicting.  Can you help me understand this?


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## melsalinas (Jun 5, 2008)

If the anesthesiologist medically directed the CRNA and only that one CRNA, you will use a QY for the anesthesiologist and a QX for the CRNA. 
If the anesthesiologist is medically directing more than one CRNA, you would then use a QK for the anesthesiologist and a QX for the CRNA
If the CRNA was not medically directed at all, you would then use the QZ modifier indicating the service was without medical direction by a physician.

I hope this helps.


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