Anesthesia modifiers — professional editing update

Effective for all claims received on and after August 1, 2024, Anthem is updating its professional claims editing system to deny anesthesia services billed without the required anesthesia modifiers. According to industry-standard coding resources including the American Society of Anesthesiologists and AMA CPT^® coding manuals, and the Anthem current commercial professional anesthesia services reimbursement policy, anesthesia modifiers are necessary to identify whether a procedure was personally performed, medically directed, or medically supervised.

The required modifiers to be reported by provider type are as follows:

If you believe you have received a claim denial in error, follow the Anthem claim dispute process.