Thursday, September 23, 2010

Assistant surgery modifier

Assistant at Surgery Modifier Fact Sheet

Definition:

• An “assistant at surgery” is a physician who actively assists the physician in charge of a case in performing a surgical procedure. The “assistant at surgery” provides more than just ancillary services.

Facts:
• Global surgery rules do not apply.
• Reimbursement equals 16% of the amount otherwise applicable for the global surgery.
• Use the “80” modifier when the assistant at surgery service was provided by a medical doctor (MD).
• Use the “82” modifier when the assistant at surgery service was provided by an MD and there was not a qualified resident available. Documentation must include information relating to the unavailability of a qualified resident in this situation.
• Use the modifier “AS” for assistant at surgery services provided by a Physician Assistant (PA) or Nurse Practitioner (NP). These claims must be submitted as assigned claims.
• Fee Schedule for Physicians’ Services – Assistant at Surgery. Indicators for services where an assistant at surgery is never paid per the Internet-Only Manual (IOM).
0 = Payment restrictions for assistants at surgery applies to this procedure unless supporting documentation is submitted to establish medical necessity.
1 = Statutory payment restriction for assistants at surgery applies to this procedure. Assistant at Surgery may not be paid.
2 = Payment restrictions for assistants at surgery does not apply to this procedure. Assistant at Surgery may be paid.

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