AdministrativeCommercialJune 1, 2024

Reminder: time-based anesthesia modifiers and claim submission

Anthem automatically adds units when certain physical status modifiers are billed with time-based anesthesia codes. Additional time should not be added on the claim since the system automatically adds the applicable units based on the modifier submitted.

Modifier

Description

P3

A patient with severe systemic disease

P4

A patient with severe systemic disease that is a constant threat to life

P5

A moribund patient who is not expected to survive without the operation

More information can be found in our reimbursement policy Professional Anesthesia Services. The modifiers are listed in the Anesthesia Modifiers section.

For more information about this and other reimbursement policies, visit the Reimbursement Policies page at anthem.com.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

CTBCBS-CM-059777-24

PUBLICATIONS: June 2024 Provider Newsletter