Using the Correct Modifiers for Anesthesia Claims

Anesthesia services submitted to BlueCross^® BlueShield^® of South Carolina and BlueChoice HealthPlan should be submitted for reimbursement using the American Society of Anesthesia (ASA) codes and appropriate modifiers. As a reminder, anesthesia modifiers indicate who performed the anesthesia service and when submitted accurately, ensures timely reimbursement. Here are a few anesthesia claims filing tips that may help avoid claims payment delays:

• If the medical doctor (MD) is solely providing the care, filing the claim with an AA modifier is appropriate. 
• If the certified registered nurse anesthetist (CRNA) is providing the care, filing the claim with modifier QK or QY is appropriate. 
• If the MD and CRNA are both providing care, the claim must be filed with modifier QK or QY or AD, when the MD is supervising. 

Should you have additional questions about billing for anesthesia services with modifiers, please read our medical policy, Anesthesia Services – CAM 012, or send an inquiry to Provider.Education@bcbssc.com.