Anesthesia Coding Alert

Question: When should I report modifier 99, and where should I record it?


Florida Subscriber


Answer: Modifier 99 (Multiple modifiers) comes into play when there are not enough spaces (in your system or the carrier-s) to hold all modifiers associated with the procedure. Most systems can accommodate at least two or three modifiers. If you have more than that, list the actual modifiers in block 19 or in the appropriate electronic space for additional information.
 
For example, the anesthesiologist personally administers monitored anesthesia care during a breast biopsy on a patient who has had heart bypass surgery. You-ll report 00400 (Anesthesia for procedures on the integumentary system on the extremities, anterior trunk and perineum; not otherwise specified) for the procedure. Because your state (Florida) requires MAC modifiers, you-ll need to report modifiers AA (Anesthesia services performed personally by anesthesiologist), QS (Monitored anesthesia care service), G8 (Monitored anesthesia care [MAC] for deep complex, complicated or markedly invasive surgical procedure) and G9 (Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition). If the system won't let you report all of these, use modifier 99 instead and list the specific modifiers in the explanation box.