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Modifier 80 and 22

  1. #1
    Default Modifier 80 and 22
    Exam Training Packages
    We have been discussing the use of the 80 assistant modifier along with the use of the 22 modifier. In what order would you put these codes when sending into the insurance company? Would you even use both of these codes together???
    Thank you for any help!

  2. #2
    Location
    North Carolina
    Posts
    3,126
    Default
    I would arrange it as 22/80.

    I think the carrier will view the primary surgeon as the one who is performing the substantially greater, bulk of the work. However, if your documentation can truly support the assistant surgeons role and prove it was also substantially greater, it's plausible.

  3. Default assistant surgeon
    what about if you have a case where there is to be an assistant surgeon and the two surgeons are in the same practice under one npi #. can you bill for that?

  4. #4
    Location
    Greeley, Colorado
    Posts
    2,045
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    Yes, you can bill for both surgeons in the same practice; as co-surgeons (if applicable) or one as an assistant surgeon.
    Lisa Bledsoe, CPC, CPMA

  5. #5
    Default
    Wait a second, one NPI# for 2 different providers? Do you mean Tax ID#?

    The NPI should be different for each provider but they can share the same Tax ID. The NPI would be how the carrier could tell it was 2 different surgeons.

    Laura, CPC

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