Wiki Modifier 80 vs 82 - Does anyone have

[DebbieP]

Does anyone have information regarding 80 modifier? Also what type of documentation do you need for Medicare to use modifier 82? Can you use both in a teaching hospital? Thank you

 

[mmelcam]

I can tell you with modifier 80 your physician does not need to dictate his own operative report. You just use the primary surgeon's operative report as documentation. Your physician should be listed on this operative report as assistant surgeon. I have never used modifier 82 so I have no information regarding that modifier.

 

[TWinsor]

For modifier 82 there needs to be documentation in the operative note that there was not a "qualified resident available" for whatever the reason. The assist does not need to dictate their own note. If you are in a teaching setting you need to use 82 for assistants, unless of course the payor does not accept this modifier then you would use 80.

 

[mmelcam]

Why would you use modifier 82 for teaching? Just curious.

 

[FTessaBartels]

82 for teaching

Melissa .. because when you are in a teaching hospital the assumption is that the residents (for whose services you cannot bill) are functioning as the assistant surgeons. So you need to use the 82 modifier that stipulates that no qualified resident was available.

 

[mmelcam]

Makes sense...Thanks

 

[elschakle]

As a fellow coder, I was interested in knowing if you ever received a satisfying answer to your question on: "Modifier 80 vs 82"? I work in a teaching physician hospital where that question comes up frequently.
Thanks for any help.
(pmandas@lmcmc.com)

 

[RebeccaWoodward*]

Take a look at 100.1.7 and begin reading there. This expands on Tessa's comment.

http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf

http://lamedicare.info/provider/datanaly/modflow/MOD80.pdf