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Appendix 1: Wisconsin Medicaid-Allowable Procedure Codes, Modifiers, TOS Codes, POS Codes, and Rounding Guidelines for CRNA and AA Services
Some procedure codes displayed within the ranges below may not be covered by Wisconsin Medicaid. Call Provider Services regarding coverage of specific procedure and type of service code combinations. The chart below is periodically revised.
Wisconsin Medicaid-Allowable CRNA and AA Services
| Service | Procedure Codes | TOS |
|---|---|---|
| Surgery | 10040-69999 | 7 (anesthesia) |
| Intubation | 31500 | 2 (surgery) |
| Vascular procedures | 36000-36248, 36488-36491, 36600-36660 | 2 allowable when anesthesia not provided |
| Invasive monitoring | 36488, 36489, 36620, 93503 | 7 |
| Radiology | 70010-79999 (Anesthesia for radiology procedures is allowed only if the complexity of the procedure and the physical condition of the patient make it medically necessary.) | 7 |
| Medicine - psychiatry | 90870, 90871 | 7 |
| Medicine - ophthalmology | 92018, 92019 | 7 |
| Medicine - special otorhinolaryngologic services | 92502 | 7 |
| Medicine - cardiovascular | 92950-92998, 93278-93660, 93724, 93731-93738, 93799, 93875-93990 | 7 |
| Medicine - pulmonary | 94799 | 7 |
Modifiers for CRNAs and AAs
| Modifier | Provider | Description |
|---|---|---|
| WP | CRNA or AA | CRNA or AA is one of two, three, or four CRNAs or AAs being medically directed |
| WD | CRNA or AA | CRNA or AA is the only CRNA or AA being medically directed |
| WJ | CRNA only | CRNA is medically supervised |
Rounding Guidelines
| Time (in minutes) | Unit(s) Billed |
|---|---|
| 1-15 | 1.0 |
| 16-30 | 2.0 |
| 31-45 | 3.0 |
| 46-60 | 4.0 |
| 61-75 | 5.0 |
| 76-90 | 6.0 |
| 91-105 | 7.0 |
| etc. |
POS Codes
| POS | Description |
|---|---|
| 0 | Other |
| 1 | Inpatient Hospital |
| 2 | Outpatient Hospital |
| 3 | Office |
| 7 | Nursing Home |
| 8 | Skilled Nursing Facility |
| B | Ambulatory Surgical Center |
POS: Place of Service
TOS: Type of Service
CRNA: Certified Registered Nurse Anesthetist
AA: Anesthesiologist Assistant
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