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CPT Modifier 23 Usage and Reimbursement


Unusual Anesthesia: Occasionally, a procedure, which usually requires either no anesthesia or local anesthesia, because of unusual
circumstances must be done under general anesthesia. This is considered as an informational modifier (like the HCPCS modifiers RT & LT).

This modifier should only be submitted with anesthesia CPT codes 00100 through 01999

Anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologist assistants (AAs) should submit this modifier to indicate that a procedure that is normally performed under local anesthesia or with a regional block required general anesthesia.

Report this modifier in the second modifier position. The modifier indicating the service was personally performed, medically directed, or medically supervised should be reported in the first modifier position.

Reimbursement:

This modifier is informational only and does not affect reimbursement

Please note:

Do not report this modifier with procedure codes that include the term "without anesthesia" in the description.

Do not report with procedure codes that are normally performed under general anesthesia.

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