CommercialAugust 1, 2024
Reimbursement policy update: Professional Anesthesia Service
Beginning with dates of service on or after November 1, 2024, Anthem will update the Related Coding section of the Professional Anesthesia Service reimbursement policy with the following:
- Added modifiers QK, QX, or QY language (removed from the policy body section).
- Removed diagnosis codes not eligible for reimbursement when reported with add-on code 99140 code list.
- Added the following statement to the Comments column for modifiers G8, G9, and QS comment column:
- May be reported in a subsequent modifier field when the service rendered is monitored anesthesia care (MAC).
- Updated physical status modifiers P3, P4, and P5 language to indicate reimbursement for the applicable additional time unit.
Section V., Qualifying Circumstances for Anesthesia will be updated to indicate that Anthem will consider qualifying circumstances to be always bundled when reported in addition to the anesthesia procedure or service provided.
The policy has been renamed as Anesthesia Services — Professional. For specific policy details, visit the New Hampshire reimbursement policy page.
Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
NHBCBS-CM-063132-24-SRS62776
PUBLICATIONS: August 2024 Provider Newsletter
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