Use These Two Modifiers to Show Anesthesiologist and CRNA Work
Question: We recently had a situation where the anesthesiologist and a certified registered nurse anesthetist (CRNA) both worked on the same patient and for the same procedure for medically necessary reasons. Is it possible to report their respective services in such a way that they’ll both be paid for their work? Illinois Subscriber Answer: It’s possible to report and bill for both providers’ work in such a situation, and Medicare may provide full payment, but you’ll need to be meticulous. According to the Medicare Claims Processing Manual, Chapter 12, you’ll need to have documentation by and for each provider that supports payment of the full fee. When preparing such a claim, you’ll need to report the services for the physician along with modifier AA (Anesthesia services performed personally by anesthesiologist); for the CRNA, append modifier QZ (Crna service: without medical direction by a physician). The Medicare Claims Processing Manual describes such situations where it’s medically necessary to have two providers as “unusual circumstances.” Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC
