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Modifier AS + 80/81/82?

  1. #11
    Jacksonville, Florida - 90417
    Default Multiple Modifiers
    Medical Coding Books

    I am not familiar with the "coding rule" about numerical before alphabetical. I have found that the modifier that more directly impacts reimbursement should be listed first. In your case, the AS modifier would be listed first as it impacts the rate of reimbursement. The 59modifier would denote a decision to pay or not to pay but not the rate of payment.

    Just my 2 cents.

    Maryann C. Palmeter, CPC, CENTC, CPCO

  2. #12
    Quote Originally Posted by Jaimee View Post
    I searched and could not find anything either, but the CSR kept telling me to "pay close attention to the order of the modifiers" so all of my claims that have 2 modifiers I am rebilling to see how they process...
    All of our claims have AS and then all other modifiers. email me if you have any questions :

  3. #13
    Default WPS guidelines
    I see the guidelines stating to use both of these, CMS states as applicable, but if you reference WPS guidance on this it sounds like they only want the 80, 81, or 82 used if a physician (MD) is the assistant. The articles I am referencing are:


    Any thoughts?
    Mandy Flagg, CPC, CEMC
    Compliance Auditor

  4. #14
    That's because AS is only for non-physician assistants, and would only be used by PA, SA, RN, etc. What I dont understand is why they want people to use both. 80/81/82 are for physicians only, and AS is for non-physicians, so by appending both you're implying that the provider is both, which is impossible, either you're a doctor or you're not... anybody else peeved about this?

  5. #15
    Charleston, WV
    I can't find anything that says 80, 81 & 82 are for physicians only. I suspect the reasoning is in the detail provided by -80, 81 & 82. -AS does not offer minimum assistant or qualified resident n/a options.
    J G Stanley, MHA, CPC

  6. Default
    I'm in Washington, so Noridian is our Medicare provider. In the IOM online Medicare Claims Processing Manual, Publication 100-04, Chapter 12, Section 110.3 - Posted 01/30/12 there is a Mediare Part B Bulletin titled "Physician Assistants Properly Billing Assistant-At-Surgery Services". It states to put the -AS first, then -80 or -81 or -82. It also talks about how these will be reimbursed..."Physican Assistant assistant-at-surgery services are paid at 85% of 16% of what a physician is paid under the Medicare Physican Fee Schedule".
    I've actually forgotten to add the -80 after the -AS and sure enough...the claim was denied. This is all new to Noridian as of beginning of 2012, last year the policy for PA-C assistant at surgery was just to use -AS. At least here in Washington that's how we were told to bill by customer service at Medicare.

  7. Default
    We always billed out our PA's as AS82 and we were paid accordingly. I've billed this way since 1997 and never had an issue.

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