Anesthesia

The Plan Maintenance - Anesthesia tab maintains information about anesthesia billing and modifiers.

Billed Anes Preference	Enter/Select the anesthesia preference to be used for the plan on the "billing side". Anesthesia Preferences define how Extreme Age, Emergency Conditions, and Physical Status are handled, so this is a required field for all plans.
Allowed Anes Preference	Enter/Select the anesthesia preference to be used for the plan on the "allowed side". Anesthesia Preferences define how Extreme Age, Emergency Conditions, and Physical Status are handled, so this is a required field for all plans.
MAC Anesthesia Type	Enter/Select the anesthesia type representing Monitored Anesthesia Care (MAC).
MAC Modifier	Enter/Select the modifier to be used for Monitored Anesthesia Care (MAC) if this payor requires a special modifer on MAC cases. An example is Medicare, which requires a QS modifier on these cases.
non-MAC Modifier	Enter/Select the modifier to be used for non-MAC services (if any). This modifier should be entered only if there is an anesthesia modifier that is used on ALL anesthesia services. Medical Direction modifiers should be entered into the Medical Direction table.
Report Modifiers on all Claim Levels	Select this option if Medical Direction Modifiers for this plan should be used on all levels of claims for this plan (primary, secondary, and tertiary). If this option is selected, this plan's modifiers will override the primary plan's modifiers when this plan is secondary or tertiary. If this option is NOT selected, then the primary plan's modifiers will print on claims for this plan when it is secondary or tertiary. The only exception is when this option is NOT selected on a Medicare plan; when Medicare is secondary it will use an AA modifier. If the option is selected and Medicare is secondary, it will use the correct modifier.
Special Med-Cal Narrative Overrides	Indicates the the plan is a Medi-Cal (CA Medicaid) plan and that special processing of the charge narrative will take place to meet Medi-Cal billing requirements.
Special Med-Cal Unit/Modifier Overrides	Indicates the the plan is a Medi-Cal (CA Medicaid) plan and that special modifiers and unit overrides will take place in the Charge Calculation to meet Medi-Cal billing requirements
Delegated Services on Z-Force Nurse Alone	Indicates that the plan is a BCBS TN plan nad that special handling of MDs and CRNAs is required to meet the delegated services requirements of BCBS TN.

This grid is used to specify what modifiers should be used on this plan for different medical directions. If the payor does not require any medical direction modifiers (such as a Commercial plan) there would be nothing set up in this grid. For a payor such as Medicare, the different medical directions (1, 2, 3, etc.) and corresponding modifiers (AA, QK, QX) are defined here.

Medical Direction	Medical Direction
Nurse Billable	Indicates if nurse charges are billable for the medical direction. Nurse charges are billable based on this indicator and the billing indicator(s) in Staff Maintenance
Mod1	First modifier to bill for physician for the medical direction
Mod2	Second modifier to bill for physician for the medical direction
Nurse Mod1	First modifier to bill for anesthetists for the medical direction
Nurse Mod2	Second modifier to bill for anesthetists for the medical direction
Res Mod1	First modifier to bill for residents for the medical direction
Res Mod2	Second modifier to bill for residents for the medical direction