What situations would require the use of modifier 23?

Modifier 23 is used to indicate that a procedure usually performed without anesthesia required general anesthesia due to unusual circumstances. This modifier is important for coding and billing purposes because it communicates to payers that there was a specific reason for the use of general anesthesia in a case that typically would not require it.

When a procedure generally does not involve anesthesia, such as certain diagnostic or minor surgical interventions, the application of general anesthesia could signify an exception due to patient factors or specific procedural complications. In such cases, modifier 23 helps clarify the necessity for the added level of anesthesia, ensuring that providers receive appropriate reimbursement for the additional resources used.

Using modifier 23, therefore, serves the purpose of outlining the unusual medical need for general anesthesia in situations that would not call for it under normal circumstances, effectively supporting the claim for the additional service rendered.