Wiki podiatry surgical assistant

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amatoj16

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I work for a podiatry office that specializes in Foot and Ankle surgeries. There are a few surgeries that might need an assistant. Could i bill for an assistant with a modifier 80 on it? The doctor thinks that insurances do not pay for assistants for podiatry . Does anyone know or have any experience in this since i am new to this practice.
 
In most CPT books the codes indicate if an assist is allowed with an -80 among other things. It's usually in a box. If it's not in your specific book check your encoder which you must have. There are a ton of NCCI edit conflicts with foot & ankle surgery, just the nature of the beast. If your assistant is a PA you will probably need to bill the modifier -AS instead.
 
amatoj16 said:
I work for a podiatry office that specializes in Foot and Ankle surgeries. There are a few surgeries that might need an assistant. Could i bill for an assistant with a modifier 80 on it? The doctor thinks that insurances do not pay for assistants for podiatry . Does anyone know or have any experience in this since i am new to this practice.
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I have attached a master list I have saved from UHC for payable codes for assistants, but you can obtain a complete list of CPT codes from your MAC provider's website. https://www.cms.gov/medicare/new-medicare-card/providers/macs-provider-portals-by-state.pdf

The 80 modifier only applies to an assistant surgeon that is a physician so if they are a healthcare professional (NP, PA, or CNS) the 'AS' modifier would be more appropriate.
 

Attachments

there are resources, Medicare being one, which will indicate whether or not an assistant is reimbursable for a given procedure.
having said that, 2 more points to make: I have never billed an assistant for Podiatry procedures. and Modifier 80 is assigned when the assistant is an MD.
modifier AS is assigned for PA assist.
 
clark.amy86 said:
I have attached a master list I have saved from UHC for payable codes for assistants, but you can obtain a complete list of CPT codes from your MAC provider's website. https://www.cms.gov/medicare/new-medicare-card/providers/macs-provider-portals-by-state.pdf

The 80 modifier only applies to an assistant surgeon that is a physician so if they are a healthcare professional (NP, PA, or CNS) the 'AS' modifier would be more appropriate.
Click to expand...
Thank you so much!! great help.
 
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