Anesthesia Coding Alert

Question: I have a case where an anesthesiologist is supervising a CRNA for only the beginning of the procedure. Would the CRNA get the QX or QZ modifier? It seems that both technically apply.

New Jersey Subscriber

Answer: You can only bill for supervision if the supervision lasted the entire duration of the procedure. Because of this, modifier QZ (CRNA service: without medical direction by a physician) is more appropriate than QX (CRNA service: with medical direction by a physician).

Also: You classify this as supervision, but the QX and QZ modifiers only apply to cases that qualify for medical direction. Verify that the anesthesiologist met all the criteria for the case to be considered medical direction before you submit either QX or QZ. If the case doesn’t meet all the criteria, it counts as medical supervision.

For a more definitive answer, check your payer’s stance on reporting the CRNA modifiers.