47 - JE Part B

Anesthesia by Surgeon: Regional or general anesthesia provided by the surgeon may be reported by adding modifier 47 to the basic service. (This does not include local anesthesia.) Modifier 47 would not be used as a modifier for the Anesthesia procedures.

Appropriate Usage

• Modifier 47 is used to report anesthesia by the attending or assistant surgeon only by adding to the basic service. (This does not include local anesthesia).

Inappropriate Usage

• Use of this modifier by the anesthesiologist is not permitted.
• Appending this modifier to CPT codes 00100 through 01999 Anesthesia Codes
• Used as a modifier for the anesthesia or local anesthesia codes.
• Do not use this modifier if the surgeon is monitoring general anesthesia performed by an anesthesiologist, Certified Registered Nurse Anesthetist (CRNA), resident, or intern.
• Do not append modifier 47 to the CPT code when the surgeon administers the regional or general anesthesia. This service is not covered by Medicare.
• Do not report modifier 47 with a surgical procedure code when the surgeon provides moderate sedation.

Procedure Codes

• Surgery services/procedures

Additional Information

• If the same physician performs anesthesia and surgery, the anesthesia is considered inclusive with the surgery. No separate or additional benefit is available for the anesthesia.
• This is considered an informational only modifier.

Resource

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Sections 20.5 and 50
• Medicare NCCI 2022 Coding Policy Manual - Chapter 1 - General Policies