Modifier 23: unusual anesthesia
Use 23 when a procedure that's normally done with no anesthesia or just local needs general anesthesia because of unusual circumstances. A common example is a patient who can't cooperate with a minor procedure. Document why. Payers vary on whether they pay, and some want the record attached.
Modifier 47: anesthesia by the surgeon
Modifier 47 goes on the surgeon's claim when the surgeon gives regional or general anesthesia themselves. Anesthesia providers don't use it. Medicare doesn't pay for it.
Other modifiers to know
For staffing modifiers like QZ, QX, QK and AA, see CRNA billing modifiers. For MAC modifiers, see MAC billing.
This article is general information, not billing, legal or tax advice. Payer rules change; always check current guidance.
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