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PAP507

Anesthesia Modifiers


Provider Administrative Policy

Section
Physician
Policy Date
February 1999
Status/Date
Revised/November 2008
Provider Type(s)
Physician  

Disclaimer

Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.

Policy

Anesthesia Modifiers

Please follow the American Society of Anesthesiologists’ (ASA) guidelines when assigning anesthesia modifiers. Blue Cross of Idaho will allow additional units as appropriate, therefore do not add these base modifier units to your time units.

When billing for anesthesia, if you use the following modifiers the corresponding units listed below will be added to the time units you supply, and the base units we assign to the procedure when the reimbursement is calculated.

Modifier

Units

P1

0

P2

0

P3

1

P4

2

P5

3

P6

0

If you modify an anesthesia code but do not charge an additional fee, or reduce your fee to a lesser unit level, this information should appear in the remarks section of the claim.

Example: If you assign a P5 modifier but only increase your charge by the equivalent of one unit, then remarks should read P5 = 1 unit.

Other Modifiers
If using a QX or QK modifier to bill for the services of a CRNA with medical direction in addition to charges for the medical direction services, Blue Cross of Idaho processes the first claim received. Reimbursement is calculated using the full allowance not a lesser percentage.

Policy History

Date Action Reason
November 2008 Revised Language added

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