Anesthesia Coding Alert

Question: We have a secondary insurance carrier that is denying claims we submit using modifier QZ. If modifier QZ is not on the claims, however, the secondary carrier will reimburse for it. The secondary carrier says it doesn't require a modifier on its claims. Can we remove the modifier from a claim after the primary insurance carrier pays it?

New York Subscriber

Answer: Removing modifier QZ (CRNA service: without medical direction by a physician) from the secondary claim is perfectly acceptable. As you've mentioned, not all carriers will accept the HCPCS medical-direction modifiers.

It pays to be sure: Don't risk your reimbursement. The smart money says that you should always check your specific secondary carrier's policy before considering submitting a claim without modifiers.

-- Answers to You Be the Coder and Reader Questions were provided by Scott Groudine, MD, an Albany, N.Y., anesthesiologist; Marvel J. Hammer, RN, CPC, CCS-P, ACS-PM, CHCO, owner of MJH Consulting in Denver; and Kelly Dennis, MBA, CPC, ACS-AP, with Perfect Office Solutions of Leesburg, Fla.