Who determines and documents physical status modifiers?

Physical status modifiers are determined and documented by the anesthesia provider. These modifiers provide critical information about a patient's physical condition prior to undergoing anesthesia and surgery. The anesthesia provider evaluates the patient and assigns a modifier that reflects their overall health status at that time, which helps in ensuring that proper anesthesia care is administered.

The documentation is essential for coding, billing, and understanding the level of risk associated with the patient's condition. Accurately capturing this information not only aids in proper reimbursement but also ensures that care providers are aware of any medical issues that may affect the surgical procedure or anesthesia management.

While the surgical team may work closely with the anesthesia provider and the patient may provide pertinent information about their health, the responsibility for formally determining and documenting these modifiers lies with the anesthesia provider. Insurance providers, on the other hand, are typically involved in the processing of claims and do not perform assessments of the patient's physical status.