Wiki Assisting Surgeon for WC claims

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stephmom21@yahoo.com

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Hello,

My Provider is a CST (certified surgical tech) & CSFA (certified surgical first assist). She has been assisting with some WC claims and we are having issues with getting paid.

We bill with an -AS modifier for ALLLLLLLL carriers. When I bill them to WC it gets denied for: Invalid modifier. When I call them I am told "our Bill review cannot advise you on how to bill". UGH I am at my wit's end!

I found on: https://dir.nv.gov/uploadedFiles/dirnvgov/content/WCS/April 2021 Billing Packet.pdf PAGE (8) to use a modifier -29, but that modifier does not exist.

Then I found on: https://view.officeapps.live.com/op.../Text-of-regulations.docx&wdOrigin=BROWSELINK (page 50) to use either -80, -81, -82 OR -AS.

Since my provider ONLY "associates" with the description of the -AS modifier, that is what I have been using.

Does anyone out there have experience OR that can point me in the right direction for research??? I am lost!
 
Work Comp usually wants 81 not AS. But I believe in NV it is -29. However, they may not be willing to pay for a CST or CSFA. Many/most only pay for MD, DO, PA, NP, or RNFA to assist. You have to check the individual work comp payer. Just because you, "bill with an -AS modifier for ALLLLLLLL carriers." doesn't mean that's correct.
You can also look up your Work Comp state rule.


Your EHR or PM system would have to have an exception loaded where a 29 could be appended. Some systems can be set to auto-change an AS or 81 to that when the associated provider type is the rendering. It's like how some systems change regular codes to G codes for the line item depending on the payer.
 
Thank you amyjph. Thankfully I use Office Ally and we mail out ALL of our claims, so I can edit my claims to have any modifier and the system will not change it before I print it.

I will submit acouple of corrected claims with the -29 mod and see what happens.

Thank you again.
 
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