Wiki Anesthesia for MRI cases in office setting

[EllieAnn]

Hi all,

Does anyone have any experience billing Anesthesia for MRI cases done in office? I need to know if you've had problems getting paid? Many of the MRI codes in Crosswalks states *** Anesthesia Care not typically required*** Would you bill 01922 with a 23 modifier in a case where maybe the patient is a child and can not lay still for the MRI?

Also, if anyone knows of any helpful sites or links that might be useful. Any help would be greatly appreciated.

Thanks,
Ellie-Ann Marchese, CCS-P, CANPC

 

[dwaldman]

I was reviewing the modifier 23 Here is what I found usually I bill the MRI and the anesthesia for and I don't put anything more on the MRI claim or the anesthesia claim then the results from the MRI and don't seem to have any problems

Question

Please provide the definition and illustration of Modifier 23.

Answer

Following is the definition and illustration of Modifier 23, Unusual Anesthesia: Occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual circumstances must be done under general anesthesia. This circumstance may be reported by adding the modifier 23 to the procedure code of the basic service. The guidelines in the surgery section of CPT indicate that the CPT Surgical Package Definition includes ?local infiltration, metacarpal/metatarsal/digital block or topical anesthesia.? Certain codes in CPT represent services performed under anesthesia (eg, 57410, Pelvic examination under anesthesia (other than local). For these codes, the 23 modifier would not be appended. Procedures that generally do not require general anesthesia may, in some cases, require general anesthesia because of the extent of the service or other circumstances. In these cases, modifier 23 is appended to the procedure code reported. Illustration of Modifier 23 The physical condition of some patients, such as patients who are mentally retarded, are extremely apprehensive, or have a particular physical condition (eg, tremors, spasticity), may require the use of general anesthesia to perform certain procedures that would normally not require anesthesia. To report these cases, append the 23 modifier to the procedure code.