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Anesthesia billing modifier QK, QX, QY, QZ, QS, AND G8,G9 • When a CRNA assumes the role of second anesthesiologist, a medical direction situation does not exist and the anesthesiologist should bill with modifier AA and the CRNA should bill with modifier QZ
Anesthesia Billing Modifiers: QK, QX, QZ, QS QY Guide Remember that only the anesthesiologist’s claim gets the QK The CRNA’s claim gets QX (we’ll get to that next) What is QX Modifier? The QX modifier is used when a CRNA is working under medical direction from an anesthesiologist
Anesthesia Payment Basics Series Codes and Modifiers Physician anesthesiologists report AA, AD, QK, or QY A CRNA or Anesthesiologist Assistant reports QX; Modifier QZ is specific to CRNAs ICD-10-CM codes are used to describe why a service or procedure was performed
Anesthesia Modifiers - Novitas Solutions Pricing modifiers (AA, QK, AD, QY, QX and QZ) should be placed in the first modifier field If QS modifier applies, it must be in the second modifier field If reporting multiple modifiers, the medical direction modifier should be listed first, followed by any additional modifiers that are needed
Modifiers AA, AD, GC, QK, QX, QY, QZ - Anesthesia Payment Modifiers Anesthesia services submitted with modifier QZ will be reimbursed at the full applicable CRNA fee schedule rate, as the CRNA personally performed the full anesthesia service without medical direction or supervision by a physician
Medically Directed Anesthesia Modifiers The CRNA (modifider QX) is reimbursed for fifty percent of each respective case QK: This is used when an Anesthesiologist provides medical direction of 2 to 4 concurrent procedures with anesthesia services by qualified individuals, such as CRNAs and AAs
What is a QZ Modifier MDA (QK QY) and CRNA (QX QZ) The payment modifiers (AA, QY, QK, QZ QX) must be in the first modifier position on the claim Claims submitted without a payment modifier will be returned to the provider
ANESTHESIA MODIFIERS - Molina Healthcare To be consistent with correct coding standards for modifier QX, and that of the description for modifier QX –effective 01 01 2020 – Physicians will no longer be reimbursed for modifier QX, as this code is only valid for CRNAs
When to Use Modifier QK in Anesthesia Coding: A Guide Solution: Modifier QK comes into play To reflect Dr Smith’s oversight for both concurrent procedures, the coding professional will append Modifier QK to the anesthesia codes for each surgical case This signifies the provision of medical direction for two or more concurrent procedures
FAQ: Anesthesia - Novitas Solutions If the medically directing anesthesiologist meets the requirements for medical direction of anesthesia services, the anesthesiologist reports modifier QK; the CRNA reports modifier QX