Wiki New to Anesthesia have a couple questions

[bridie25]

Question 1) I found a few articles that say P1 to P5 modifiers are not recognized by Medicare. Is this true? is there a CMS article to back this up?

Question 2) This practice is doing Anesthesia billing for Gastro only, when a patient comes in for a colonoscopy or EGD is it necessary to code all non procedure related dx codes for example: Diabetes, Hypertension, Obesity

I don't think these should be added as they have nothing to do with the procedure performed.

 

[lmathews]

True, Medicare does not recognize the P1 to P5 modifiers.

As for the additional dx codes, this could be a requirement by the payor or LCD for instance depending on the type of anesthesia technique, a secondary dx needs to be indicated to support the technique.

Hope this helps.

 

[Melissa*Ever*Evolving]

I agree with this.

Include the physical status qualifying diagnoses even when you cannot capture the physical status P1-P5 modifiers, i.e. Medicare.

Just to clarify on a point, you need to prove why the patient needed this level of anesthesia care vs. moderate sedation.

~Melissa, CPC