Anesthesia Coding Alert

Question: Which modifier should we use when CRNAs are involved in a case?

Ohio Subscriber

Answer: You have two modifiers to consider when reporting a CRNA’s service. They are:

• QX – CRNA service: with medical direction by a physician
• QZ – CRNA service: without medical direction by a physician.

Medical direction occurs when an anesthesiologist is involved in up to four concurrent procedures where the anesthesiologist is physically present. When you’re reporting services for a CRNA who is medically directed by a physician, remember to include the correct medical direction modifier on the physician’s claim: QK (Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals) or QY (Medical direction of one certified registered nurse anesthetist [CRNA] by an anesthesiologist).

Extra tip: Some insurance companies might not recognize the CRNA separately. In that situation, no modifier may be needed.