Anesthesia Coding Alert

Before you can code medical direction for anesthesia services during surgery, the anesthesiologist must document his or her presence during all critical or key portions of the procedure. These guidelines - known as the seven rules of medical direction - must each be met before you can code the anesthesiologist's case as medically directed (by appending modifier -QY, Medical direction of one certified registered nurse anesthetist [CRNA] by an anesthesiologist; or -QK, Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals).
 
To code medical direction, the anesthesiologist must:
 
perform a preanesthesia examination and evaluation
  prescribe an anesthesia plan
  personally participate in the most demanding procedures of the anesthesia plan, including induction and emergence
  ensure that any procedure in the plan that he or she does not perform is performed by a qualified anesthetist
  monitor the course of anesthesia administration at intervals
  remain physically present and available for immediate diagnosis and treatment of emergencies
  provide the indicated postanesthesia care.