Part B Insider (Multispecialty) Coding Alert

 Although it's unusual to use the -G8 modifier with MAC, you might need it for some services: "Some bone biopsies, some neurosurgery cases - including surgery for Parkinson's - and even some amputations may be done under MAC," Barbara Johnson says.
 
You'd use the -G9 modifier with a Column B code to indicate the patient has, or has had in the past, a severe cardiopulmonary condition, Cigna explains. Or, you can use it to show that there's a significant risk of exacerbation to a stable patient during the procedure. "The theory behind it is that MAC anesthesia would not normally be used. However, since the procedure is 'deep complex, or markedly invasive,' it requires anesthesia by an anesthesiologist or other anesthesia provider," says Kelly Dennis of Central Florida Anesthesia Associates in Leesburg.