Anesthesia Coding Alert

In the September 2001 Medicare Provider News, published by Cahaba Government Benefits Administrators, Mississippi's Part B Medicare carrier, Cahaba announced it retired its monitored anesthesia care (MAC) policy effective July 1, 2001, calling it "outdated and inefficient."
 
When contacted, customer-service representatives stated the carrier's claims-review personnel will no longer review submittals for MAC. The process was becoming "too time-consuming." Providers may omit modifiers -QS (monitored anesthesia care service), -G8 (monitored anesthesia care [MAC] for deep complex, complicated, or markedly invasive surgical procedures) and -G9 (monitored anesthesia care for patient who has history of severe cardio-pulmonary condition) on anesthesia codes. The Mississippi representative advised anesthesiologists to maintain documentation supporting the administration of MAC in case claims are questioned.
 
Cahaba is also the Medicare Part A and B carrier for Alabama, the Part B carrier for Georgia, and the Part A carrier for Iowa. Alabama and Georgia customer-service representatives were contacted to see if the current MAC policy has changed in those states. Although the Alabama representative could provide no information (citing privacy regulations), the representative from Georgia stated that there has been no formal change in their processing of MAC claims. Cahaba in Georgia still requires providers to append the appropriate MAC modifier to claims and to be able to provide documentation regarding the medical necessity of the anesthesia service. If Cahaba changes its policies in Georgia, it will be announced to providers in the monthly newsletter.
 
Coders and billers in Mississippi, and throughout the United States, should check with Cahaba or their local Medicare carrier to ensure that MAC guidelines are followed when submitting claims.