Modifier 47 | Anesthesia by Surgeon Explained

Modifier 47 describes the administration of regional or general anesthesia by a surgeon performing a procedure. This modifier differentiates the anesthesia services provided by the surgeon from those provided by an anesthesia provider.

1. What is modifier 47?

Modifier 47 is a CPT code modifier used to indicate that the surgeon who performs a procedure also administers regional or general anesthesia. This modifier differentiates the anesthesia services provided by the surgeon from those provided by an anesthesia provider.

2. When to use the 47 modifier?

Modifier 47 should be used when the surgeon who performs a procedure also administers the regional or general anesthesia. This is typically done in cases where an anesthesia provider is unavailable, or the surgeon has specialized training in anesthesia administration. Modifier 47 should not be used for local anesthesia.

3. Description

The official description of modifier 47 is “anesthesia by surgeon.” This modifier indicates that the surgeon who performs a procedure also administers the regional or general anesthesia.

4. Examples

Examples of procedures that may require modifier 47 include:

• Epidural administration by an obstetrician during labor and delivery
• Spinal anesthesia administration by a surgeon during a spinal surgery
• General anesthesia administration by a surgeon during a surgical procedure

5. Documentation

Documentation requirements for using modifier 47 include the following:

• The surgeon’s note should indicate that they administered the anesthesia
• The type and amount of anesthesia administered should be documented
• The start and stop times for the anesthesia administration should be documented
• The surgeon’s note should indicate that they monitored the patient during the anesthesia administration

6. Billing

To bill for a procedure with modifier 47, the code for the procedure should be assigned twice. The first time without modifier 47 and the second time with modifier 47. The claim should also include the units of time spent monitoring the patient on anesthesia. Modifier 47 should not be appended to anesthesia codes.

7. Common mistakes

Common mistakes that medical coders make when using modifier 47 include:

• Using modifier 47 for local anesthesia
• Failing to document the anesthesia administration in the surgeon’s note
• Failing to include the units of time spent monitoring the patient on anesthesia in the claim

To avoid these mistakes, coders should carefully review the documentation and ensure that all requirements for using modifier 47 are met.

8. Other modifiers related to modifier 47

Other modifiers related to modifier 47 include:

• Modifier 22: Used to indicate that a procedure required additional work due to its complexity or unusual circumstances
• Modifier 23: Used to indicate that a procedure required prolonged anesthesia due to the patient’s condition
• Modifier 59: Used to indicate that a procedure was distinct or separate from other procedures performed on the same day

9. Tips

When using modifier 47, it is important to:

• Ensure that the surgeon has the appropriate training and credentials to administer anesthesia
• Document the anesthesia administration in the surgeon’s note
• Include the units of time spent monitoring the patient on anesthesia in the claim

10. Conclusion

Modifier 47 indicates that the surgeon who performs a procedure also administers the regional or general anesthesia. It is important to use this modifier correctly and to meet all documentation and billing requirements.