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TnRushFan

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My providers recently started documenting the use of Assistant Surgeon in absence of a qualified resident. Is it appropriate to use -82 in the Out Pt Surgery Dept?
My CPT code payment indicator allows its use but the surgery was performed on an out pt basis.
-82 is not listed in the approved ASC or Out Pt modifiers.

Thoughts are appreciated...
 
The modifier is not approved for use by hospital outpatient departments or ASCs - that just means that the facility cannot bill this modifier, not that a physician cannot use it for an outpatient procedure. If your physician is part of a teaching program but no qualified resident in that program was available to assist, then the physician who assisted would bill and be paid for that service using this modifier. At least that is my understanding of how it is used.
 
thomas7331 said:
The modifier is not approved for use by hospital outpatient departments or ASCs - that just means that the facility cannot bill this modifier, not that a physician cannot use it for an outpatient procedure. If your physician is part of a teaching program but no qualified resident in that program was available to assist, then the physician who assisted would bill and be paid for that service using this modifier. At least that is my understanding of how it is used.
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I have a couple of vascular surgeons who have billed a couple of procedures with modifier 82. Do you have any reference materials that explains how to use or bill modifier 82? I have to present this info next month. Appreciate any help you can provide.

Thank you!
 
The MACs usually all have fact sheets on modifiers.
Examples:

Assistant at Surgery Modifiers Fact Sheet

www.novitas-solutions.com www.novitas-solutions.com
Use the "82" modifier when a qualified resident surgeon is not available in a teaching facility:
The unavailability of a qualified resident surgeon is a prerequisite for use of this modifier and the service must have been performed in a teaching facility.
The circumstance explaining that a resident surgeon was not available must be documented in the medical record. This modifier is not intended for use by non-physician providers.


Search assistant at surgery here: https://www.cms.gov/regulations-and-guidance/guidance/manuals/downloads/clm104c12.pdf
 
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