Wiki Anesthesiologist and CRNA full services one case

[Melissa*Ever*Evolving]

Hello, My provider is asking me for an example of when it would be appropriate to bill for the full Anesthesiologist's charge (AA modifier) and also the CRNA's full charge (QZ modifier) for one case.

I have found that this is possible, but I do not see any examples anywhere.
Everything I see only says things like:

Office of Worker's Compensation Programs (OWCP) Anesthesia Service and Reimbursement Policy (section 3.7.4)~

"In unusual circumstances, when it is medically necessary for both the Anesthesiologist and the anesthetist to be completely and fully involved during a procedure, full reimbursement for the services of each provider is allowed. Each provider must submit documentation to support payment of the full fee. The physician would bill OWCP using modifier AA and the anesthetist would bill OWCP using modifier QZ as referenced in section 2.2"

My provider wants an example. I cannot think of when it would be appropriate.

Please help, anyone?

~Melissa, CPC

 

[Melissa*Ever*Evolving]

Just to add...

We are looking to do EGD and colonoscopy procedures. Would this ever apply for this type of procedure?

Thanks for all your help!
~Melissa, CPC

 

[Michele Hannon]

That situation will be rare. The record will need to be provided with clear documentation of the need for two pair of hands. Endoscopy will usually not qualify. (there are no absolutes)

An example would be multiple trauma with massive transfusion/resuscitative anesthetic.

 

[Melissa*Ever*Evolving]

That makes sense. Thank you for your input!
~Melissa, CPC