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Modifier AS + 80/81/82?

  1. #1
    Location
    Greeley, Colorado
    Posts
    2,045
    Question Modifier AS + 80/81/82?
    Exam Training Packages
    This is a new one to me. One of our A/R reps was informed by a rep at Noridian that we are required to add mod 80/81/82 as well as AS for PA assists effective 10/1/11. I cannot find any publication notifying us of this new requirement. Does anyone have a CMS link or even better, one for Noridian?
    TIA!!
    Lisa Bledsoe, CPC, CPMA

  2. #2
    Default
    This is actually not new. We have had to do this for several years. I am in Michigan so we have WPS Medicare.

    https://www.cms.gov/manuals/downloads/clm104c12.pdf

    110.3 - PA Billing to Carrier
    (Rev. 1, 10-01-03)
    B3-16001, B3-15044, B3-2156, PM-B-99-16
    A. Modifiers
    Physician Assistant as assistant at surgery should be identified with a modifier AS.
    Billers must identify PA assistant-at-surgery services with the following modifiers as applicable:
    Assistant surgeon services billed with modifier “-80”;
    Minimum assistant surgeon services with modifier “-81”;
    Assistant surgeon services (when assistant resident surgeon not available) with modifier 82.
    NOTE: 80, 81, and 82 are paid at 65 percent of 16 percent. No other reductions for minimum services take place.

    This is on page 172 of the manual.

    Laura, CPC, CPMA, CEMC

  3. #3
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    I see it in the manual; but have never been instructed to do this for Trailblazer or Noridian...until today.
    Lisa Bledsoe, CPC, CPMA

  4. #4
    Location
    Seattle First Hill
    Posts
    126
    Default
    Lisa,

    I was just told the same thing today. Our billing office told me that they called Medicare several times to confirm and were told that it has been in their online manual for some time but they are just now starting to enforce it. I wish I would have known this sooner!

    ~Kirsten, CPC

  5. #5
    Location
    Greeley, Colorado
    Posts
    2,045
    Default
    In our office, the question has now come up as to whether or not the manual is being interpreted correctly. There is a MLN article that specifically applies this scenario to Method II CAH's where the PA has reassigned his/her billing rights to the hospital. Our PA's have not done this; so if we start adding another modifier it is going to change the reimbursement they receive as well. Any other thoughts?
    Lisa Bledsoe, CPC, CPMA

  6. #6
    Location
    Greeley, Colorado
    Posts
    2,045
    Default Clarification from Noridian
    Lisa Bledsoe, CPC, CPMA

  7. #7
    Location
    Albany, Oregon
    Posts
    53
    Default Modifiers AS + 80-81-82
    Greetings!

    Our practice has just learned about this 'new" rule also. We, too, are Noridian.

    We have only appended modifier-AS when our PA-C assisted the surgeon.

    Our question now is -- In which order should the modifiers be written?
    My inclination is 80-AS, but our home office is insisting that it should be AS-80 and I'm not so sure about that.

    How are you all submitting the claims? If I can find a reference or CMS documentation, that would be great.

    I appreciate your "assist"ance!
    Pat Kidd, CPC, CGSC
    Albany Surgical Associates
    Albany, OR
    pkidd@samhealth.org

  8. Default
    We just got a new PA-C at the end of December, and it has taken Cahaba Medicare until May to complete his credentialing. I am getting paid when I use just AS modifier, but, when I use another modifer, say 59, and use the coding rule that states numerical before alphabetical, those codes get denied for invalid use of modifier.. I can't find a publication that says the rule has changed for 2012......

  9. #9
    Default
    Quote Originally Posted by Jaimee View Post
    We just got a new PA-C at the end of December, and it has taken Cahaba Medicare until May to complete his credentialing. I am getting paid when I use just AS modifier, but, when I use another modifer, say 59, and use the coding rule that states numerical before alphabetical, those codes get denied for invalid use of modifier.. I can't find a publication that says the rule has changed for 2012......
    We are submitting claims with just AS modifier. I was trying to find something about this new rule on Cahaba's website but could not find it.

  10. Default
    Quote Originally Posted by armen View Post
    We are submitting claims with just AS modifier. I was trying to find something about this new rule on Cahaba's website but could not find it.
    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...

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