Anesthesia Coding Alert

Question: Our locum tenens anesthesiologist directed one CRNA during a case. Which modifiers should I append to the code and in what order?


Pennsylvania Subscriber

Answer: The rule of thumb is that modifiers affecting payment go before informational modifiers. In your scenario, report modifiers QY (Medical direction of one certified registered nurse anesthetist [CRNA] by an anesthesiologist) and Q6 (Service furnished by a locum tenens physician) first.

If the physician administered monitored anesthesia care (MAC) during the procedure, coders in states that require MAC modifiers (such as Arizona, Colorado or Florida) would also append modifier QS (Monitored anesthesia care service) to the procedure code.