Anesthesia Coding Alert

Question: Can an anesthesia provider other than an anesthesiologist, such as a CRNA or resident, bill an arterial line to Medicare, and does it require a medical direction modifier?

Indiana Subscriber

Answer: Medicare recognizes certified registered nurse anesthetists (CRNAs) for payment and expects you to report the arterial line (36620 (Arterial catheterization or cannulation for sampling, monitoring or transfusion (separate procedure); percutaneous)) under the provider who performed the service. Because the placement of an arterial line is a “surgical” procedure and not an “anesthesia” procedure, you do not need to report a medical direction modifier.

If the arterial line was placed by a resident and teaching requirements were met, you would report 36620 with modifier GC (This service has been performed in part by a resident under the direction of a teaching physician) appended.

The Centers for Medicare & Medicaid Services (CMS) has an excellent resource for teaching anesthesiologists available at www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/teaching-physicians-fact-sheet-icn006437.pdf.