General Surgery Coding Alert

Question: What are the appropriate modifiers to append for providers who assist during surgeries?

New Yok Subscriber

Answer: According to Medicare Administrative Contractor (MAC) National Government Services, Inc. (NGS), there are four modifiers that may be appropriate to designate provider assistance during surgery:

Physician modifiers

• 80 (Assistant surgeon)
• 81 (Minimum assistant surgeon)
• 82 (Assistant surgeon (when qualified resident surgeon not available)

Nonphysician practitioner (NPP) modifier

• AS (Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery)

However, you need to check your state’s laws about scope of practice before reporting an NPP’s assistance at surgery, as some states, like New York, do not include surgery in scope of practice for providers like nurse practitioners (NPs).

Note, too, that teaching hospitals have more restrictive conditions for coverage than other settings because of the availability of residents, NGS says.

Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC