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PA's Billing Medicaid for Assists

  1. #1
    Loveland, CO
    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
    North Carolina
    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
    Loveland, CO
    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
    North Carolina
    This is strictly for NC Medicaid. NC Medicaid does not recognize the AS modifier.

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