AS Modifier-We were told

Sbisc723

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We were told by Medicare today that claims for an assistant at surgery, who is a NPP, should be billed with the AS modifier as well as 80,81 or 82. Has anyone else run into this problem or had denials do to this?
 

bradhamilton

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We were told by Medicare today that claims for an assistant at surgery, who is a NPP, should be billed with the AS modifier as well as 80,81 or 82. Has anyone else run into this problem or had denials do to this?
As far as I know, the requirement for 80/81/82, in addition to the AS modifier, is only for CAH hospitals - read up on the requirements necessary for a CAH designation, and then find out if your facility is designated as one.
 

Pam Brooks

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We use -80 for an assistant MD surgeon....and -AS for a midlevel assistant. Check with your payers, though. NH Medicaid doesn't accept the -AS, they want the -80 for all levels of assistants.
 

penguins11

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Different Medicare payers have different criteria. For our PA's we bill 82 AS to Medicare. To the Medicare replacement plans we bill either 80 AS, 82 AS or just AS depending on their individual criteria.
 

stephmhut

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what are the documentation guidelines for using modifier 80? I am coding for OB/GYN docs who often assist each other in deliveries and surgeries, but seem to think the assistant doesnt need to document, is this true? Any suggestions?
 

penguins11

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The assistant does not need to dictate a separate OR or note. It is sufficient to list the dr as the assistant at surgery and add a sentence at the end of the OR. For our physician assistants, we put a sentence at the end that states that the PA was present for the entire procedure and assisted with suction, irrigation, instrumentation.
 
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