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Minnesota AUC Administrative Simplification
 

Anesthesia TAG Final Recommendations to
the Administrative Uniformity Committee


  1. Anesthesia units should be reported as minutes, i.e. one hour would be reported as sixty units, one hour and ten minutes would be reported as seventy units. The time is not reported separately on the HCFA 1500 billing form.


  2. The ASA codes should be used to bill for anesthesia services.


  3. Qualifying circumstances should be accepted as reportable services. All Qualifying Circumstances should be billed with the appropriate Anesthesia modifier, i.e. AA, QK etc. on a separate line item from the primary procedure.


  4. Physical Status Modifiers P1 through P6 should be billed as defined by the Physicians' CPT Manual and the ASA despite current limitations of some providers' and payers' billing and processing systems. The P modifiers should be reported as either the second or third modifier position, consistent with CPT billing methodology.


  5. Standardized reporting of anesthesia modifiers among payers. The modifiers listed below are recommended:


    1. AA M.D. performed
    2. QY M.D. directed - for supervision of 1 case
    3. QK M.D. directed - for supervision of 2 - 4 cases
    4. AD M.D. directed - for more than 4 cases
    5. AE M.D. directed - for supervision of residents
    6. QZ CRNA performed
    7. QX CRNA directed
    8. QS monitored anesthesia care services

    These modifiers were chosen as appropriate because:

    1. they are recognized and defined by HCFA and are level II modifiers listed in the HCFA Common Procedural Coding
    2. they are considered as industry standards for reporting in the first modifier field for anesthesia services; and
    3. they would provide consistency for secondary claims processing, enabling cross-over claims to be more easily processed with less opportunity for errors.


  6. Professional anesthesia services are to be billed using the HCFA 1500 billing form to be consistent with the Minnesota Administrative Simplification Act.

These recommendations were forwarded by the Anesthesia TAG to the Data Definitions TAG for implementation (see CMS 1500 Manual , Appendix 6).

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