CPT modifier
Modifier 23: Unusual anesthesia
Modifier 23 is a CPT modifier. In plain terms: General anesthesia was given for a procedure that is usually done with local or no anesthesia.
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- Modifier
- 23
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- General anesthesia was given for a procedure that is usually done with local or no anesthesia.
- How it is used
- Used on the anesthesia claim when the patient's situation required general anesthesia.
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
The CPT descriptor is AMA copyright and is not shown here. The description above is written by Rivvi. Read the CMS guidance linked above for Medicare's rules.
Anesthesia
- AAAnesthesia services performed personally by anesthesiologist
- ADMedical supervision by a physician: more than four concurrent anesthesia procedures
- QKMedical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
- QXCRNA service: with medical direction by a physician
- QYMedical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist
- QZCRNA service: without medical direction by a physician
- QSMonitored anesthesia care service
- G8Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedure
- G9Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
- 47Anesthesia by the surgeon
Related modifiers
- AAAnesthesia services performed personally by anesthesiologist
- ADMedical supervision by a physician: more than four concurrent anesthesia procedures
- QKMedical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
- QXCRNA service: with medical direction by a physician
- QYMedical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist
- QZCRNA service: without medical direction by a physician
- QSMonitored anesthesia care service
- G8Monitored anesthesia care (MAC) for deep complex, complicated, or markedly invasive surgical procedure
- G9Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
- 47Anesthesia by the surgeon
Related pages
Questions
What does modifier 23 mean?
Modifier 23 is a CPT modifier. In plain terms: General anesthesia was given for a procedure that is usually done with local or no anesthesia.
Is modifier 23 a CPT or a HCPCS modifier?
23 is a CPT (Level I) modifier. The AMA maintains CPT modifiers. Two-character codes with a letter, such as GT or XU, are HCPCS Level II modifiers from CMS.
Where does modifier 23 go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
When is modifier 23 used?
Used on the anesthesia claim when the patient's situation required general anesthesia.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.