Name of Manual - Blue Cross and Blue Shield of Minnesota

Coding Policies and Guidelines (Anesthesia)
Overview Blue Cross and Blue Shield of Minnesota accepts the CPT
American Society of Anesthesiologists codes (ASA), 00100-
01999, for anesthesia services billed on the 837P claim format. We
do not accept surgical codes submitted with anesthesia modifiers.
All services for the same operative session should be submitted on
the same claim.
Full-time Anesthesia
Services
11-2
We define full-time anesthesia as follows:
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Full-time anesthesia services are provided personally by the
anesthesiologist to an individual patient. The anesthesiologist
is physically present in the specific operating room, personally
performs the induction and emergence, and directly monitors
the patient throughout the entire operative procedure. The
anesthesiologist may leave the specific operating suite to
perform necessary administrative duties. However, the
anesthesiologist does not perform other revenue-generating
procedures when billing full-time anesthesia services. This
definition includes one-on-one supervision of a certified
registered nurse anesthetist (CRNA) present in the same
operating suite.
Use modifier AA for full-time physician services.
Blue Cross also considers anesthesia services provided by
independent CRNA and physician-employed CRNA to be fulltime
if the above criteria are met and medical direction is not
provided by a physician.
Modifier QZ would be used for full-time CRNA services.
The HCPCS level II modifiers (AA and QZ) should be listed
in the first modifier position.
The anesthesia modifiers should only be reported with the CPT
anesthesia codes 00100-01999. Other services (such as nerve
blocks), may be performed by an anesthesiologist or CRNA,
but should not be submitted with an anesthesia modifier.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (02/21/12)