Wiki 82 and AS

[Lisa Bledsoe]

If in a teaching hospital and a qualified resident is not available but an NPP is the assist, would you report both modifiers or just one?

 

[LLovett]

CMS directs to use both.

http://www.cms.hhs.gov/transmittals/downloads/R1620CP.pdf

But I will say we have had claims get paid with only the AS. Not sure why when it goes against their policy...

Laura, CPC, CEMC

 

[Lisa Bledsoe]

Thanks Laura. It appears that the private payors have their own agenda on this issue. Go figure.

 

[svanhorn73]

80 vs AS

Commercial payors recognize the AS modifier. Medicare you can only bill with the 80 modifier

 

[LLovett]

If you are getting paid by Medicare with just the 80 modifier you may be getting paid too much. That indicates the assist was an MD/DO, the AS is what identifies the NPP.

Laura, CPC, CEMC

 

[Lisa Bledsoe]

Commercial payors recognize the AS modifier. Medicare you can only bill with the 80 modifier

80 would be incorrect if the assistant is not a physician. If an NPP assists you must use AS - especially with Medicare.