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Medicare Denials for Assistant Surgeon Modifier 80 for S&I Codes


Santa Clara, CA
Best answers
Hello, could someone tell me if it is possible to bill medicare for radiology supervision and interpretation codes (S&I) for medicare, for 7000 codes? Example 75716-26-80, and others? We are receiving denials for assistant surgeon modifiers on these codes.

Thank you,


True Blue
Best answers
Assistant surgeon services are generally not paid for the majority of radiology codes.

The Medicare Physician Fee Schedule (PFS) is set up with an assistant surgeon indicator code for every covered CPT and HCPCS code. If you look up the code in the PFS and find the assistant at surgery column, only codes with an indicator of '2' in that column will be paid. Codes with an indicator of '0' can be paid if you submit supporting documentation for the medical necessity of the assistant, and codes with a '1' will always be denied.