When billing for anesthesia services, using the informational QS modifier alerts commercial and government payers that monitored anesthesia care (MAC) was provided. Before adding this modifier, though, here are a few guidelines to remember.
- The QS modifier is for MAC only.
- The QS modifier should be applied to anesthesia procedure codes only.
- The start and stop time of the anesthesia service must be included on the claim in addition to the QS modifier.
- The QS modifier should always be in the second modifier slot after one of the documentation modifiers that allow payers to process the anesthesia claim properly.
Anesthesia documentation modifiers that should be used in the first modifier slot on anesthesia claims are as follows:
- AA – Anesthesia services performed personally by an anesthesiologist.
- QK – Medical direction by a physician of two, three, or four concurrent anesthesia procedures.
- AD – Medically supervised by a physician, more than four concurrent anesthesia procedures.
- QY – Medical direction of one CRNA/AA (Anesthesiologist’s Assistant) by an anesthesiologist.
- QX – CRNA/AA (Anesthesiologist’s Assistant) service with medical direction by a physician.
- QZ – CRNA service without medical direction by a physician.
For more information, review each payer’s policy regarding the QS modifier. For Indiana and Michigan providers, review the WPS Medicare’s Modifier QS Fact Sheet.
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