Plus: Know when exceptions might apply.
Before appending modifiers QY (Medical direction of one certified registered nurse anesthetist [CRNA] by an anesthesiologist) or QK (Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals) to your anesthesiologist’s claim, verify that he or she meets all seven criteria necessity. Also know that certain services can be performed without interrupting medical direction, keeping your reimbursement at a higher level.
The seven criteria for claiming medical direction are:
CMS does allow for a few exceptions to these criteria:
If you’re uncertain regarding whether a situation meets the criteria or falls under an exception, always check with your local payer before submitting the claim.