Health Information Management

Q&A: Correct use of modifiers -80 and -AS

JustCoding News: Outpatient, May 2, 2012

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QUESTION: Can you explain the difference between modifier -80 (assistant at surgery by another physician) and –AS (physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery)? Medicare requires us to use both modifiers for our physician assistants. We have been instructed to use -AS first and -80 second for all Medicare claims submissions. Is this correct?

ANSWER: As you stated, modifier -80 identifies a healthcare professional who supports the efforts of the surgeon during a procedure. Note that “by another physician” is NOT part of this modifier description. Modifier -AS specifies the qualifications of this assistant.

No conflict exists between these two modifiers. Medicare is just stating that it wants to know who (qualifications) before they know what (assisted in surgery). The last part of the modifier-AS description (“…for assistant at surgery”) is unclear as to whether this professional is assisting the primary surgeon or generally during the surgery. Modifier -80 eliminates the ambiguity.

Editor’s note: Shelley C. Safian, PhD, MAOM/HSM, CCS-P, CPC-H, CHA, of Safian Communications Services in Orlando, Fla., answered this question. She is a senior assistant professor who teaches medical billing and insurance coding at Herzing University Online in Milwaukee, Wis. Email her at ssafian@embarqmail.com.

This answer was provided based on limited information submitted to JustCoding. Be sure to review all documentation specific to your own individual scenario before determining appropriate code assignment.

Need expert coding advice? Submit your question to Senior Managing Editor Michelle Leppert, CPC-A, at mleppert@hcpro.com, and we’ll do our best to get an answer for you.



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