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Insurance wants me to put modifier with code 00170. i put 47 and the denied it even if it's the most appropriate modifier. is there other modifier i need to put for my oral surgeon doing the sedation himself?
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Rank: Member
Joined: 10/13/2015(UTC)
Posts: 11
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Hi Guest!
Great question. According to the modifier 47 fact sheet provided by a Medicare contractor (WPS), modifier 47 would actually be reported on the basic service instead of on the anesthesia CPT code.
As for the common modifiers to use with the anesthesia service, below are some modifier options:
AA - Anesthesia services performed personally by an anesthesiologist
AD - Medical supervision by a physician; more than four concurrent anesthesia procedures
G8 - Monitored anesthesia care (MAC) for deep complex, complicated or markedly invasive surgical procedure
G9 - Monitored anesthesia care (MAC) for a patient who has a history of severe cardiopulmonary condition
QK - Medical direction of two, three or four concurrent anesthesia procedures involving qualified individuals
QS - Monitored anesthesia care service
QX - CRNA service; with medical direction by a physician
QY - Medical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist
QZ - CRNA service; without medical direction by a physician
23 - Unusual anesthesia - Used to report a procedure which usually requires either no anesthesia or local anesthesia; however, because of unusual circumstances must be done under general anesthesia. Coverage/payment will be determined on a "by-report" basis.
Hope this helps!
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