The Office of the Inspector General (OIG) within the Department of Health and Human Services has published its Work Plan for 2013. On the list of Medicare issues on which the OIG will focus next year is the following:
Anesthesia Services—Payments for Personally Performed Services (New)
We will review Medicare Part B claims for personally performed
anesthesia services to determine whether they were supported in
accordance with Medicare requirements. We will also determine whether
Medicare payments for anesthesiologist services reported on a claim with
the “AA” service code modifier met Medicare requirements. Physicians
report the appropriate anesthesia modifier to denote whether the service
was personally performed or medically directed. (CMS’s Medicare Claims Processing Manual,
Pub. No. 100-04, ch.12, § 50) The service code “AA” modifier is used
for anesthesia services personally performed by an anesthesiologist, and
the “QK” modifier is used for medical direction of two, three, or four
concurrent...
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