Results 1 to 5 of 5

PA's Billing Medicaid for Assists

  1. #1
    Location
    Loveland, CO
    Posts
    10
    Default PA's Billing Medicaid for Assists
    Medical Coding Books
    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

  2. Default
    What is the Medicaid denial code?

  3. #3
    Location
    North Carolina
    Posts
    3,126
    Default
    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)

  4. #4
    Location
    Loveland, CO
    Posts
    10
    Default
    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!

  5. #5
    Location
    North Carolina
    Posts
    3,126
    Default
    This is strictly for NC Medicaid. NC Medicaid does not recognize the AS modifier.

Similar Threads

  1. Replies: 4
    Last Post: 04-08-2015, 11:21 AM
  2. Billing CNM assists on c-sections
    By Leandra in forum OB/GYN
    Replies: 1
    Last Post: 05-21-2012, 08:21 AM
  3. Billing Physician Assistants under supervisor as first assists
    By adenyer in forum Billing/Reimbursement
    Replies: 1
    Last Post: 11-01-2011, 11:11 AM
  4. billing 2 sugical assists on a surgery..??
    By 1073358 in forum Cardiology
    Replies: 1
    Last Post: 03-07-2008, 10:30 AM
  5. Billing PA Assists BCBS Michigan
    By acbarnes in forum Medical Coding General Discussion
    Replies: 0
    Last Post: 12-28-2007, 02:44 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?

Login

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.