Anesthesia Coding Alert

Question: Our anesthesiologist participated in two cases whose times overlapped. One claim is Medicare, and the other is Blue Cross. Should I include modifier QK for Medicare only if the concurrent case is also Medicare, or should I report it anytime it applies?

Oklahoma Subscriber

Answer: The concurrencies count for all cases, regardless of insurance carrier, even though you may not need to report the concurrency modifiers to all payers. Because of this, you should check every claim for concurrency. Report concurrency modifiers as appropriate, even if you don't include performance modifiers with all the cases in question.

Extra tip: Although a medically directing physician (designated with modifiers 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) can overlap his time between cases, times for the medically directed CRNA (designated with modifier QX, CRNA service: with medical direction by a physician) should never overlap. The CRNA cannot be involved with more than one case at a time.