Anesthesia Modifier Reporting

Date Issued: 7/16/2018

The following policy on anesthesia reporting is in accordance with policy from the Centers for Medicare & Medicaid Services (CMS).

Physicians are required to report the appropriate anesthesia modifier when reporting for anesthesia. The modifier explains whether the service was personally performed, medically directed, medically supervised, or monitored anesthesia care.

Certified registered nurse anesthetists (CRNAs) also must report the appropriate anesthesia modifier. It explains whether the service was or wasn’t performed under physician supervision.

It is not appropriate to bill multiple anesthesia modifiers AA, AD, QK, QX, QY, and QZ on the same claim line. These modifiers are considered mutually exclusive and will be denied.

Here are the appropriate modifiers for anesthesia services:

  • AA (Anesthesia services performed personally by an anesthesiologist)
  • AD (Medical supervision by a physician: more than 4 concurrent anesthesia procedures)
  • G8 (Monitored anesthesia care [MAC] for deep complex, complicated, or markedly invasive surgical procedure)
  • G9 (Monitored anesthesia care [MAC] for patient who has history of severe cardiopulmonary condition)
  • QK (Medical direction of 2, 3, or 4 concurrent anesthesia procedures involving qualified individuals)
  • QS (Monitored anesthesiology care services)
  • QX (Qualified non-physician anesthetist with medical direction by a physician)
  • QY (Medical direction of one qualified non-physician anesthetist by an anesthesiologist)
  • QZ (CRNA without medical direction by a physician)


Last Updated: 07/16/18
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