Anesthesia Coding Alert

Question: One of our secondary insurance carriers denies claims we submit with 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: Yes, you can remove modifier QZ (CRNA service: without medical direction by a physician) from the secondary claim. As you've mentioned, not all carriers will accept the HCPCS medical-direction modifiers.

Don't automatically remove modifier QZ, however, and 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.