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Physician Assistants

  1. Smile Physician Assistants
    Medical Coding Books
    What modifiers are used and how do you use them?

  2. #2
    I bill surgical charges w/ the AS modifier, for Medicaid (Florida) pts I use the 80 modifier. I think there are some other carriers that want 80 instead of AS but I don't see the back end of my claims, so I couldn't tell you.
    For E&Ms we bill all claims under the PA's NPI numbers, no special modifier on those. Hope this answers your question.

  3. Default
    It depends on your insurance carrier. I would check with each of your provider service reps. For surgery with Medicare, we bill 82 AS, some of our other carriers, PA BCBS requires 80 AS, railroad medicare wants just an AS. As far as office visits, most of the commercial carriers want them billed under the doctor, with Medicare we bill under the Physician Assistant unless incident to rules apply which you may want to look up on Medicare's website. Basically if the physician has seen the patient first and established the plan of care than subsequent visits you can bill under the doctors name with the doctors NPI, as long as he is also in the office, (he does not have to see the patient but has to be available). However, this is a pretty simple explanation, incident to can be complicated so I would pull up the specific rules on Medicare's website.

  4. #4
    White Plains, New York Chapter
    For Workers' Comp/No Fault Auto Insurance cases in New York State you can use modifier PA. For surgical procedures you can use AS, PA, or 83. Mod 83 can also be used for Nurse Practitioners that act as surgical assistants.

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