Anesthesia Coding Alert

Answer: A good place to start is with your local Medicare Administrative Contractor (MAC). National Government Services (NGS) is the MAC for Illinois and has several excellent resources.

When reporting cases in which a physician is training medical residents, the positioning of your modifiers is important, as NGS and many payers require pricing modifiers in the first position and the informational modifier identifying a resident is involved in the second position. Thus, you would list a modifier such as -AA (Anesthesia services performed personally by anesthesiologist) first and information modifier GC (This service has been performed in part by a resident under the direction of a teaching physician) second.

For example, if the anesthesiologist is overseeing two resident cases, they are allowed to report modifiers AA and GC on each case, providing documentation requirements are met.

Keep in mind: Modifier GC modifier applies to all services, not just general anesthesia.

For further study: Find NGS guidance on appropriate use of anesthesia modifiers at www.ngsmedicare.com/web/ngs/modifi ers?selectedArticleId=1625038.