Anesthesia modifiers we bill: AA, QZ, and QS
ClearBilling puts three modifiers on claims: AA (anesthesiologist personally performed), QZ (CRNA without medical direction), and QS (monitored anesthesia care). We do not bill medical direction. Always confirm against current CMS and payer policy for the date of service.
AA: personally performed
The anesthesiologist personally performed the case. Typically 100% of the allowed amount to the physician. A factory that assumes every room is a CRNA room will overwrite this.
QZ: CRNA without medical direction
The CRNA performed the case without medical direction. Typically 100% to the CRNA or CRNA group. Hang QX on it because a hospital template said so, and you split a fee that was never a split.
QS: monitored anesthesia care
QS is informational. It tells the payer the service was MAC, not general. It rides with AA or QZ. Payment is still the unit formula. Skip it on a MAC list, or put it on a general anesthetic, and you pick a fight you did not need.
What we do not bill
QK, QY, QX (medical direction) and AD (medical supervision) are a different practice model. If that is how you staff, we are not your biller. Physical status P1 to P6 still applies on the cases we do bill, when the payer recognizes them.
FAQ
Straight answers for practices comparing anesthesia billing companies.
What modifier does an independent CRNA use?
QZ. Add QS when the service is monitored anesthesia care.
Do you bill QK, QY, or QX?
No. AA, QZ, and QS only.
Do you teach our providers these modifiers?
We will tell you what the claim needs. Documentation still has to happen in the OR.
Related
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