Allowable modifiers for family planning services and anesthesia services are listed in the following table.
Modifier |
Description |
|---|---|
QX |
CRNA or (AA) service: with medical direction by a physician |
QZ |
CRNA service: without medical direction by a physician |
QY |
Medical direction of one CRNA (or AA) by an anesthesiologist |
QK |
Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals |
AA |
Anesthesia services performed personally by anesthesiologist |
80 |
Assistant surgeon |
26 |
Professional component |
TC |
Technical component |
Allowable modifiers for family planning drugs and supplies are listed in the following table.
| Modifier | Description | Notes |
|---|---|---|
| GD | Units of service exceeds medically unlikely edit value and represents reasonable and necessary services | Use this modifier with procedure code S4993 to identify emergency contraception. |
| UD | Medicaid level of care 13, as defined by each state | Use this modifier when dispensing drugs acquired under the 340B Program. |