tci Medicare Compliance & Reimbursement - 2011 Issue 1

Part B Coding Coach: Modifier 23 Could Apply -- If Your Physician Performed Anesthesia That's 'Unusual'

Knowing enough details about procedure, location can give you the green light. The time of anesthesiologists only working on cases in the OR are long gone -- your providers might be called to help with procedures in any number of places these days. Many of these cases could merit modifier 23 (Unusual anesthesia), so ask yourself three important questions when deciding whether to append 23. Where Did the Service Take Place? You can append modifier 23 to many procedures that take place outside the OR if your physician provides sufficient documentation.Radiology: Radiologists perform an ever-growing range of procedures...

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