Wiki CRNA being denied a duplicate

[neecen]

I am billing for an Ohio Anesthetist the following:
mod QY when the Anesthetist supervises one CRNA
mod QK when the Anesthetist supervises two CRNA

I am getting denials from MMO, Anthem, Aetna, UHC and MCR sometimes on the CRNA stating it is a duplicate and sometimes they deny the anesthetist stating duplicate. Is there another modifier I should be using?

 

[cmcgarry]

I am billing for an Ohio Anesthetist the following:
mod QY when the Anesthetist supervises one CRNA
mod QX when the Anesthetist supervises two CRNA

I am getting denials from MMO, Anthem, Aetna, UHC and MCR sometimes on the CRNA stating it is a duplicate and sometimes they deny the anesthetist stating duplicate. Is there another modifier I should be using?

For the anesthesiologist (MD) use:
QY when supervising one CRNA procedure
QK when supervision two, three or four concurrent CRNA procedures

For the CRNA, use:
QX when supervised (medical direction) by a physician
QZ without medical direction by a physician.

If you are using QX on the anesthesiologist, that is incorrect.

Hope this helps,

 

[neecen]

Lucinda, this is a big help. Thank you so much.

 

[frankmmedbiller]

I am also being denied for dup i bill for 1 procedure and use qx qs for crna I am located in NY... I am also getting denials saying that the plans don't cover crna's and was told by a oxford rep to bill under the MD once with qyqs and again w/ qxqs can this be right? please help

For the anesthesiologist (MD) use:
QY when supervising one CRNA procedure
QK when supervision two, three or four concurrent CRNA procedures

For the CRNA, use:
QX when supervised (medical direction) by a physician
QZ without medical direction by a physician.

If you are using QX on the anesthesiologist, that is incorrect.

Hope this helps,

 

[ohiocoder101]

came across your post, was wanting to know, are you billing JUST for crna? or is your practice anesthesiologist/crna?

if you are billing ONLY for crna, you would use qz only
if you are billing anesthesiologist/crna, you use qk/qx
if you are billing anesthesiologist/crna and its one to one ratio you bill qy/qx

if your group is crnas only, the md cannot bill anesthesia codes, they are there just for supervision only., ie-surgeron is overseeing crna.

hope this helps

 

[frankmmedbiller]

Thank you for your help