Monitored anesthesia care billing: QS on the claim, time from the record
QS reports monitored anesthesia care. It is not a pricing modifier. It rides with AA or QZ. ClearBilling bills MAC lists for anesthesiologists and independent CRNAs. We do not bill medical direction. USA-based, woman-owned, 100% onshore.
What QS is
QS tells the payer the service was MAC, not general or regional. Payment is still (base + time + modifying units) times the conversion factor, with AA or QZ as the pricing modifier. Skip QS on a MAC case, or slap it on a general anesthetic, and you invite a medical-necessity fight or a downcode.
Where this shows up
GI endoscopy, ophthalmology, pain procedures, and office-based lists. High volume, short cases, and documentation that a general biller treats like 'sedation.' We take start and stop from the anesthesia record and keep QS aligned with what was actually delivered.
What we do not mix in
Medically directed MAC (QK/QY with QX) is not our model. If a factory has been billing your MAC rooms as directed care, that is a reason to switch, not a reason for us to start doing QK.
FAQ
Straight answers for practices comparing anesthesia billing companies.
Do you bill QS with AA and with QZ?
Yes. QS is informational. The pricing modifier is still AA or QZ.
Is MAC paid differently from general?
The unit formula is the same. Payer medical-necessity rules and the QS modifier are not. We code from the record, not from the word sedation on a superbill.
Do you bill medical direction on MAC rooms?
No. AA, QZ, and QS only.
Related
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