modifier 23

Modifier 23 – Description, Guidelines & Reimbursement

The 23 modifier can be reported for unusual anesthesia. The description, billing guidelines and reimbursement for this modifier can be found below.

Modifier 23 Description

The 23 modifier can be used for 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).

Billing Guidelines For The 23 Modifier

Modifier 23 should only be submitted with anesthesia CPT codes 00100 through CPT 01999. Anesthesiologists, Certified Registered Nurse Anesthetists (CRNAs) or anesthesiologist assistants (AAs) should submit the 23 modifier to indicate that a procedure that is normally performed under local anesthesia or with a regional block required general anesthesia.

Report modifier 23 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.

Do not report the 23 modifier with procedure codes that include the term “without anesthesia” in the description.

Do not report modifier 23 with procedure codes that are normally performed under general anesthesia.

Reimbursement

Modifier 23 is informational only and does not affect reimbursement.

Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *