Anesthesia Coding Alert

Question: What practitioner modifier should I use to report 00520 (Anesthesia for closed chest procedures [including bronchoscopy]; not otherwise specified)? I originally submitted the claim with modifier -AA (Anesthesia services performed personally by anesthesiologist), but the claim was returned because the physician is not an anesthesiologist.

New Jersey Subscriber

Answer: Practitioner modifiers vary based on who provides the service, not what procedure the physician performs. Using modifier -AA indicates that an anesthesiologist performed the service.

The first question you should answer is, Who provided the anesthesia if it wasn't an anesthesiologist? Once you've answered this question, you can refile with the correct modifier. If the surgeon administered anesthesia, you should use modifier -47 (Anesthesia by surgeon). If another physician who is not part of the anesthesia department performed the service, a conscious sedation modifier might be appropriate. If a nurse practitioner provided anesthesia, modifier -SA (Nurse practitioner rendering service in collaboration with a physician) might apply.