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Wiki PA's Billing Medicaid for Assists

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hortonwl

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Loveland, CO
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I can't seem to get a sure answer on this: Does Medicaid ever accept PA's as assistants on surgical procedures? I have a slew of denials for orthopedic procedures for which the surgeon used a PA as an assistant and these assist charges are all being denied. I have called Medicaid twice and they gave me the run around and tried to direct me to an online source, but I still couldn't find any good information. I don't want to send these to be written off if I don't have to! Please help!....Thanks!

Whitney CPC-A
 
Our state allows PA's to assist on those procedures that allow an assistant (and supported by documentation); however, our region requires modifier 80 to denote the assistant (rather than AS)
 
Is modifier 80 still appropriate to use if the assistant at surgery is not a qualified physician? Modifier AS specifies PA's and other non-physicians as assistants at surgery, modifier 80 doesn't specify anything except 'assistant at surgery'; I have been told to only use modifier 80 when a qualified physician is the assistant- is this incorrect?

I have denials for all sorts of PA assist ortho codes: 27447, 27486, 22612, 22840, 22851, 20936...the list goes on and on.

Thanks again!
 
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