Results 1 to 5 of 5


  1. #1
    Lexington, Kentucky
    Default Medicare
    Clearnace Sale
    Can you help with assistant surgeons on cpt 43770-AS using this medicare
    denying? why? thanks

  2. #2
    North Carolina
    According to Medicare's fee schedule, assistants are payable for this procedure. What type of denial reason did you receive from Medicare?
    Rebecca CPC, CPMA, CEMC

    Your click COUNTS...

    CLICK to give FREE mammograms!

  3. #3
    CMS requires not only the AS to identify the assistant is a NPP, they also require either 80, 81, or 82 as well.

    Medicare pays for a surgical assistant when the procedure is authorized for an assistant and the person performing the service is a physician, physician assistant (PA), nurse practitioner (NP) or a clinical nurse specialist (CNS).
    To facilitate payment, CMS (under authority of 42 CFR Section 414.40) has established uniform national definitions of services, codes to represent services, and payment modifiers to the codes, to include the use of payment modifiers for assistant at surgery services.
    To bill for these services, you should use Modifier 80 (assistant surgeon), 81 (minimum assistant surgeon), or 82 (when qualified resident surgeon not available). You should also use Modifier AS when you need to indicate that a PA, NP or CNS served as the assistant at surgery. Be aware that when you use Modifier AS, you must also use Modifier 80, 81, or 82 because using these modifiers without modifier AS indicates that a physician served as the surgical assistant. Claims that you submit with modifier AS and without modifier 80, 81 or 82 will be returned to you.

    I know the MLN is talking about CAH but this rule applies to all settings for an assistant, its just the easiest link to find.

    I know a lot of claims get paid with just the AS, my personal opinion is this happens for the same reason a lot of claims get denied in error, they don't always pick up the 2nd, 3rd, etc modifier, and these have actually been paid in error.

    Laura, CPC, CPMA, CEMC

  4. #4
    In what order should this be? Should you put 80-AS or AS-80?

    Any help would be appreciated.

  5. #5
    The AS should be first, then the appropriate 80, 81, or 82.

    Laura, CPC, CPMA, CEMC

Similar Threads

  1. Medicare Annual Wellness and Welcome to Medicare visits
    By Borlickd in forum Medical Coding General Discussion
    Replies: 5
    Last Post: 10-04-2013, 07:31 AM
  2. Replies: 1
    Last Post: 05-17-2012, 12:27 PM
  3. Replies: 1
    Last Post: 01-18-2011, 12:54 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.