When is modifier 80 used

We love to share knowledge on medical coding. Do follow us on twitter and google plus to get regular updates. View all posts by Jitendra M. Notify me of follow-up comments by email. Notify me of new posts by email. Table of Contents. Related Posts. Our health plan will reimburse for assistant at surgery when the non-physician provider is a nurse practitioner, physician assistant or clinical nurse specialist.

Other provider types, including registered nurse without first assist credentials and certified surgical technician will not be reimbursed for assistant at surgery. The assistant at surgery must report the same codes as the surgeon. An exception to this is when the surgeon bills a global code e. In that case, the assistant at surgery must bill the specific surgery code e. The same multiple procedure fee reductions and clinical edits apply to the assistant at surgery as the primary surgeon.

When multiple procedures are performed where only some of the codes are eligible for assistant at surgery reimbursement, only the eligible codes will be reimbursed to the provider billing for the assist. Modifier reimbursement is subject to any reductions set by CMS guidelines and any applicable provider contract language. Search Advanced search….

New posts. Search forums. If you are a member and have already registered for member area and forum access , you can log in by clicking here. If you've forgotten your username or password use our password reminder tool. To start viewing messages, select the forum that you want to visit from the selection below.. JavaScript is disabled. Must be used with Type of Service 8 codes. Modifier 80, 81, Denote assistant surgeons.

Should be submitted on those surgical procedures where an assistant surgeon is warranted. NOTE: Physicians acting as assistants cannot bill as co-surgeons. Modifier Description Adjustment Rate Modifier If additional procedure s , including add-on procedures s are performed during the same surgical session, separate code s may also be reported without the modifier 62 added.

All claims must be billed according to CMS guidelines. Practitioner credentials with the appropriate corresponding modifier must be on the claim. Physician providers billing for assistant surgeon services should use modifier 80, 81, or 82 for both Medicare and commercial plans.

Non-physician providers should use modifier AS for both Medicare and commercial plans. Non-physician providers billing for assistant surgeon services that qualify for reimbursement with modifier AS are: Medicare Plans. The physician was a MD that performed the assistant surgeon duties.

The provider coded the same CPT as the surgeon and modifier Will the service be reimbursed?