IV sedation modifier

[niermanpm]

Hi I was have submitted the code 00170 for general anesthesia performed by my Oral Surgeon with wisdom teeth extractions and used the modifier of 47 and I used to get paid but I am now getting it denied and I am not sure if they have a new modifier they want. I hope you can help. Sharalee

[Jeremy Hobbs]

what modifier to use

[niermanpm]

Hi Guest! Yes it does sound like you may want to consider a different coding scenario for this. Modifier 47 would typically be appended to the procedure itself that the anesthesia is being performed for, instead of the using CPT 00170. Medicare, for example, lists the following as the correct and incorrect use of modifier 47: Correct Use – Regional/general anesthesia provided by surgeon/attending surgeon only – Append to basic surgical service/procedure only Incorrect Use – Surgeon performs both surgery/anesthesia, separate payment not allowed – Anesthesiologist not covered with this modifier – Do not use with anesthesia codes or local anesthesia – Do not use with moderate sedation (CPT 99143 – 99145) – Do not use for monitoring general anesthesia provided by Certified Registered Nurse Anesthetist (CRNA), intern, anesthesiologist or resident Here is a link to the source of this information: When reporting 00170 on it”s own, some payer require one of the following modifiers: AA – Anesthesia services performed personally by anesthesiologist AD – Medical supervision by a physician: more than four concurrent anesthesia procedures QK – Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals 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 For example, Empire BCBS requires use of these modifiers for anesthesia services: Hope this helps!

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