Anesthesia Coding Alert

Question: A conference speaker said Medicare pays an extra unit for modifier -AD if the physician was present during induction. Is this correct?


Georgia Subscriber

 
Answer: Yes, carriers can recognize an additional time unit if the physician documents his presence at induction. Coders commonly report this by appending either modifier -AD (Medical supervision by a physician: more than four concurrent anesthesia procedures) or modifier -23 (Unusual anesthesia) to the claim. Some carriers require "present at induction" noted in the narrative section of the claim form. You can do this either electronically or by paper claim, depending on your software.

Georgia Medicare doesn't publish specific instructions for reporting modifier -AD. Because of this, you could follow both directives (making the notation on the form and appending the modifier) to increase your chances of being reimbursed for the extra unit.

-You Be the Coder and Reader Questions were answered by Leslie S. Johnson, CPC, an anesthesia coder with Medical Income Concepts Inc. in Houston.