Wiki 80 Modifier

[asnelling]

I am in need of some advice on the 80 modifier. For an assistant surgeon (not a co-surgeon) I know to append the 80 modifier to the assistant surgeon's claim, but I am questioning the documentation part of it. I am getting conflicting information. Per the CPT assistant, each surgeon must have their own documented reports, but everyone I talk to states that this is not the case. They think that only the primary surgeon has to document.Does anyone have any refernces on this. Any information is greatly appreciated.

Thanks,
Amie: rolleyes:

 

[danehy]

I am in need of some advice on the 80 modifier. For an assistant surgeon (not a co-surgeon) I know to append the 80 modifier to the assistant surgeon's claim, but I am questioning the documentation part of it. I am getting conflicting information. Per the CPT assistant, each surgeon must have their own documented reports, but everyone I talk to states that this is not the case. They think that only the primary surgeon has to document.Does anyone have any refernces on this. Any information is greatly appreciated.

Thanks,
Amie: rolleyes:

In the past it was that the asst surgeon did not do documentation, but know if you need to appeal or send notes to get payment you have nothing to back an appeal with without an op note. I have all my surgeons who are the asst do their own documentation.

 

[Nieca Bronson]

Nieca

Hi Amie,
The primary/attending physician has to document in the operation report that your doctor was the assistant. The primary surgeon should also indicate why an assist was needed. So your physician does not have to dictate a separate operation report.
In the case of each physician dictating their own operation reports, that is only applicable if they are co-surgeons. In that case each would append the -62 modifier.
I have experience billing both scenarios, but unfortunately I don't have the original reference information.
Hope that helps,
Nieca

 

[RebeccaWoodward*]

There is a great article in the AAPC January 2008 Coding Edge; page 38. I have shared this article with my surgeons and for the most part, it went over well. Now that the surgeons specify the role of the assistant, denials are less frequent.