Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > Modifiers
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 01-06-2009, 01:21 AM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Default Modifier AS vs 80

There is a debate in my office as to whether or not PA's and NP's should use AS or 80. My co-worker is under the impression that AS is only for Medicare...which I disagree. I was taught and still believe that AS is for a non-physician assistant at surgery. If I am wrong, please let me know. If I am correct, does anyone have anything "in writing" that I can present to my co-worker? Thanks all!
__________________
Lisa Bledsoe, CPC, CPMA
Reply With Quote
  #2  
Old 01-06-2009, 01:40 AM
RebeccaWoodward* RebeccaWoodward* is offline
True Blue
 
Join Date: Apr 2007
Location: North Carolina
Posts: 3,129
RebeccaWoodward* will become famous soon enough
Default

My area of the world requires AS for non-practioners. The only exception is Medicaid...they do require 80. Below are a couple of our main carriers.

Medcost=Adjustment for Charges Made by an Assistant Surgeon:
Charges by credentialed MD assistant surgeons will be limited to 20% of the
MedCost allowable amount unless your contract states otherwise. Credentialed non-MDs will be limited to 14% of the MedCost allowable amount unless your contract states otherwise. Charges for assistant surgeons are not allowed unless the presence of an assistant surgeon is necessary due to the complexity of the procedure or the condition of the patient. To assure accurate repricing, MedCost requests that all providers file assistant surgeon charges with the full surgeon rate, applying the 80, 81, 82, or AS modifiers. MedCost will determine the allowable expense based on the policy and procedures in place for the modifier and provider of service billed. Please note: MedCost only reprices the claim. The claim administrator makes payment consideration for assistant surgeon charges based on the plan design.


UHC=Assistant surgeons who are not physicians should submit the identical procedure code(s) as the primary surgeon with the following modifier to represent their service(s):

Modifier HCPCS Level II Description
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery

BCBS NC=Billing/Coding/Physician Documentation Information
This policy may apply to the following codes. Inclusion of a code in this section does not guarantee that it
will be reimbursed. For further information on reimbursement guidelines, please see Administrative Policies
on the Blue Cross Blue Shield of North Carolina web site at www.bcbsnc.com. They are listed in the Category
Search on the Medical Policy search page.
Applicable Codes:
Co-Surgeon modifiers are -62 or -66.
Assistant surgeon modifiers are -80,-81, or -82.
Physician assistant modifier is -AS.
Reply With Quote
  #3  
Old 01-06-2009, 01:42 AM
LLovett LLovett is offline
True Blue
 
Join Date: Apr 2007
Posts: 1,637
LLovett is on a distinguished road
Default

I am not aware of it being Medicare only. We use it for all our carriers when we have a PA assisting in surgery. With Medicare you are supposed to use both the AS and the appropriate 80, 81, or 82 modifier together.

http://www.cms.hhs.gov/ContractorLea...ads/JA6123.pdf

That is a medicare link but the definition of the AS and 80 modifiers in HCPCS and CPT seem clear enough. The 80 by itself indicates another MD or DO assisted, when you add the AS that clarifies that it was a PA, NP, or CNS.

That is my understanding, but if someone has information to the contrary I would be interested in seeing it.

Thanks

Laura, CPC
Reply With Quote
  #4  
Old 01-06-2009, 02:47 AM
Lisa Bledsoe Lisa Bledsoe is offline
True Blue
 
Join Date: Apr 2007
Location: Greeley, Colorado
Posts: 2,043
Lisa Bledsoe is on a distinguished road
Talking

Ladies - THANK YOU!
__________________
Lisa Bledsoe, CPC, CPMA
Reply With Quote
  #5  
Old 09-30-2013, 10:07 AM
stullvs stullvs is offline
New
 
Join Date: Apr 2007
Posts: 3
stullvs is on a distinguished road
Default AS vs 80

Claims submitted with modifier AS and without modifier 80, 81 or 82 are returned ... this is an exerpt from a Medicare document.
Reply With Quote
  #6  
Old 09-30-2013, 02:27 PM
RebeccaWoodward* RebeccaWoodward* is offline
True Blue
 
Join Date: Apr 2007
Location: North Carolina
Posts: 3,129
RebeccaWoodward* will become famous soon enough
Default

Are you quoting a denial or guideline from your MAC?

Per Palmetto GBA:

HCPCS Modifier AS

Assistant Surgeon (non-physician)
•Physician assistant, nurse practitioner or clinical nurse specialist services who participated as an assistant to a surgeon

CPT Modifier 80
Assistant Surgeon (Physician)
•Surgeon who participated as an assistant to a surgeon

CPT Modifier 81
Minimum Assistant Surgeon
•Surgeon who participated as an assistant to a surgeon

http://www.palmettogba.com/palmetto/...navmenu=%7C%7C
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 04:03 AM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC