Modifier AS

aguelfi

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Has anyone used this modifier AS for and ARNP/PA who assists in sx? I'm wondering if this is for commercial insurance or Medicare.
 

Kris Cuddy

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Modifier AS is for all carriers. We've got an orthopaedic office with a PA and they do many surgeries together with TSA, for every carrier where TSA is used we bill the PA service using the supervising physician as the provider on the claim and modifier AS to denote it was TSA and generate the lesser reimbursement amount. Hope that helps.

Kris
 

aguelfi

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Our NPP's aren't credentialed w/ commercial ins. Would these be billed Incident to?
 

Kris Cuddy

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Because with TSA the service is billed under the surgeon's name alone, and the modifier AS denotes the TSA portion of the service, there's no need to be worried about the NPP not being credentialed with commercial carriers. Especially when most commercial carriers won't/don't credential them.

Two separate claims will be submitted:

1) Surgeon's own services with full charges

2) TSA service(s), with reduced charge(s) and modifier AS on each line billed, this will be billed using the surgeon's name and NPI/provider ID numbers, the modifier AS tells the carrier that it was technical surgical assistance.

It's recommended for the NPP to document their own separate surgical report for what they did.

Hope this helps.

Kris
 

hopegwd

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Nurse Practitioner

We have just hired a nurst practitioner for our practice, and are they able to bill for an assist at surgery just like a physician assistant bills? I bill for a physician assistant now, but we have never had a nurse practitioner.

Thanks,
Hope
 

mbort

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I am at an ortho practice with 2 PA's. We use the AS modifier for almost all carriers. We have run across a couple of workers comp carriers that do not recognize the AS and request that we use the 81 instead. For Medicare and Medicaid it is important to go through provider enrollment (CMS 855I form for Medicare) to get them a provider number otherwise you WILL NOT get paid.

Hope this helps
Have a GREAT weekend :)
Mary
 

Kris Cuddy

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Mary,

Thanks, I forgot about workers comp, yes they don't recognize AS but do recognize 81.

Also, NP's and PA's ought to be the same for TSA, the AS modifier is for Assistant at surgery service and does not specify whether PA or NP.

Hope that helps.

Kris
 
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