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multiple assist fees

  1. #1
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    Default multiple assist fees
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    Is anybody getting rejections from insurance companies stating they will only pay for primary procedure assist fee? (Aetna -for sure)
    i.e. 34802-80 gets paid but 34812-80 gets denied.
    Thanks for any input

  2. #2
    Default
    34812 is a payable procedure for an assistant surgeon but you need to find their policies on on billing the 80 modifier. Also, if you can, review your provider's contract to see if it is listed how an assistant will be paid, if all else fails; ask Aetna for their policy on billing modifiers.

  3. #3
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    Quote Originally Posted by kdocpc View Post
    Is anybody getting rejections from insurance companies stating they will only pay for primary procedure assist fee? (Aetna -for sure)
    i.e. 34802-80 gets paid but 34812-80 gets denied.
    Thanks for any input
    Maybe the problem is with modifier 80? Maybe you need AS?
    CPT Modifier -80, assistant at surgery. This includes MD, DO, and DPM provider types and is an assistant surgeon providing full assist to the primary surgeon.
    HCPCS Level II modifier -AS, a non-physician assistant at surgery. This would include PA, CNS, CRNFA, RNFA, NP, LPN, DDS, DMD, and surgical technician provider types, subject to contract eligibility.

  4. Default
    Can you really use Modifier AS for PA, CNS, CRNFA, RNFA, NP, LPN, DDS, DMD, and surgical technician provider types when the the AS modifier description only identifies "Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery"?

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