What modifier is not used with anesthesia procedures?
Asked by: Lenny Ebert Sr. | Last update: September 17, 2025Score: 4.1/5 (15 votes)
What is the one modifier that is not used with anesthesia procedures?
There are instances where multiple procedures are performed but modifier 51 is not appropriate. Modifier 51 is not appended to add-on codes.
When should modifier 52 not be used?
Modifier -52 should not be used if there is another specific procedure code that appropriately describes the lesser or reduced service that was actually performed; the other procedure code is the most appropriate code and should be reported.
What is modifier 74 used for?
Modifier -74 is used by the facility to indicate that a surgical or diagnostic procedure requiring anesthesia was terminated after the induction of anesthesia or after the procedure was started (e.g., incision made, intubation started, scope inserted) due to extenuating circumstances or circumstances that threatened ...
What are the modifiers used in anesthesia?
Modifiers are two-character indicators used to modify payment of a procedure code or otherwise identify the detail on a claim. Every anesthesia procedure billed to OWCP must include one of the following anesthesia modifiers: AA, QY, QK, AD, QX or QZ.
Medical Coding CPC Review - Anesthesia CPT and Modifiers
Can modifier 53 be used on anesthesia codes?
Usually, modifier 53 is used with surgical and diagnostic CPT codes. Many payers do not require modifier 53 for anesthesia CPT codes. Anesthesia reports the anesthesia code and the time for the discontinued procedure after the start of anesthesia.
Which service is not included with anesthesia services?
Other monitoring services (such as intra- arterial, central venous and Swan-Ganz) are not included.
What is the 73 modifier for anesthesia?
Modifier 73: This modifier indicates the procedure was discontinued or terminated before planned anesthesia had been provided. The medical record documentation should reflect the reason for the cancellation.
What is modifier 47 used for?
Modifier code 47 represents anesthesia by the surgeon. The modifier should only be used to represent general anesthesia or a regional block. It should not be used to represent local anesthesia by the surgeon. Local anesthesia is included in the global fee for the surgery and should not be billed separately.
What is the 52 modifier for anesthesia?
Appropriate usage
To indicate partial reduction of services for which anesthesia is not planned. Append modifier to the reduced procedure's CPT code. Ambulatory surgical centers (ASC) use modifier 52 to indicate the discontinuance of a procedure not requiring anesthesia.
What is modifier 54 used for?
Modifier 54
When a physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding this modifier to the usual procedure code.
What is modifier 51 used for?
CPT guidelines explain the 51 modifier should apply when “multiple procedures, other than E/M services, are performed at the same session by the same individual. The additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s).”
What is the modifier 77 for anesthesia?
Lay Term. Append modifier 77 to a procedure or service that a different provider repeats after another provider performed the initial procedure.
When to use modifier 52 or 53?
I. Modifier -52 is used to report “reduced services.” II. Modifier -53 is used to report “discontinued procedure.” (For outpatient/ASC facility charges, see Coding Policy 39.0.)
What is modifier 25 not used for?
Modifier 25 should not be used when: ❌ The sole purpose of the encounter is for the procedure (e.g., lesion removal), and there is no documented medical necessity for a separate E/M service.
What is a 74 modifier used for?
Modifier 74 appended to anesthesia or surgical procedures when discontinued. AFTER anesthesia administration induced or procedure initiated. ASC or outpatient hospital only. Due to medical complications, extenuating circumstances, or threat to patient well-being.
What is the 59 modifier used for?
Definitions. Modifier 59 describes a distinct procedural service, and is used to identify procedures and services that are not normally reported together.
What is a 79 modifier used for?
Modifier 79 is used to indicate an unrelated procedure performed by the same physician during the postoperative period of the original surgery. When the procedure is related to the original surgery or is a staged (anticipated) surgery, it falls under the global period and should not use Modifier 79.
What is the modifier 78 for anesthesia?
Modifier 78 is used to report an unplanned return to the operating or procedure room, by the same physician, following an initial procedure for a related procedure during the post-operative period.
What is the 72 modifier?
Modifier 72: Resumed Service Post-Surgical
Highlighting non-routine care, allowing practices to bill for medically necessary treatments without denials.
Who Cannot go under anesthesia?
In addition to the elderly, people who have conditions such as heart disease (especially congestive heart failure), Parkinson's disease, or Alzheimer's disease, or who have had a stroke before are also more at risk. It's important to tell the anesthesiologist if you have any of these conditions.
Does Blue Cross cover anesthesia?
The spokesperson added, "To be clear, it never was and never will be the policy of Anthem Blue Cross Blue Shield to not pay for medically necessary anesthesia services. The proposed update to the policy was only designed to clarify the appropriateness of anesthesia consistent with well-established clinical guidelines.”