Anesthesia Coding Alert

Question: The CRNA provided a patient's pre-op evaluation and ocular anesthetic, then the patient was monitored during cataract surgery by a facility nurse (the CRNA was not medically directed). I am billing only for the CRNA's face-to-face time. How should I report it?

Nevada Subscriber

Answer: The correct anesthesia code is 00142 (Anesthesia for procedures on eye; lens surgery), which has a base value of 4. Append modifier QZ (CRNA service: without medical direction by a physician) to show the work was done by a CRNA who was not under the medical direction of an anesthesiologist. Ocular anesthesia is normally moderate sedation, so also append modifier QS (Monitored anesthesia care service).

The time units associated with your claim will show that the CRNA placed the anesthetic but was not present during the case. Some payers might expect you to include modifier 52 (Reduced services) on the claim to illustrate the less-than-usual amount of care provided.

However, do not report modifier 52 unless required by specific policy as the CRNA's payment will already be reduced based on the time reduction.