jenny_ou84
Guest
I work for a a company that bills for RNFA's and CST, and a couple PAs and NP that work as surgical assistants. I know you bill an 81 modifier with the CST and RNFA's and an AS modifier for any PA or NP. The issue I am having is Anthem is stating that they want an AS modifier for PA, NP, RNFA, and CST's. The modifiers in the CPT book and according to Medicare clearly state that an 81 modifier is for a minimal assist, which would be the CST and RNFA, then an AS modifier is only for PA's and NP's. Can Anthem change their description of the AS modifier to include RNFA's for their policies and reimbursement procedures? I'm afraid to bill Anthem with an AS modifier for a provider that does not have the credentials to use the AS modifier. I'm concerned this could be a fraud issue if we use an AS modifier for an RNFA or CST, rather than the 81 modifier for a minimal assist. Any thoughts on this subject? I would appreciate any advice!