81 - JE Part B
Modifier 81
Minimum assistant surgeon
Instructions
Modifier 81 is appended to the procedure code for an assistant surgeon who assists an operating or principal surgeon during part of a procedure. Check the Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor Lists. Column A indicates if assistant at surgery is allowed.
Correct Use
- Append to appropriate code when more than one assistant is involved or if one person assists during a portion of surgery. Includes physicians providing minimal assistance to primary surgeon. Must be used with Type of Service 8 codes.
This modifier identifies surgical assistant services
- Indicates exceptional medical circumstances exist
- Indicates primary surgeon has policy of never involving residents in preoperative, operative or postoperative care of his/her patients
Claim Coding Example
- Fee Schedule Indicator Descriptor 2 = Payment restriction for assistants at surgery does not apply to this procedure. Assistant surgeon may be paid.
| Treatment Description | CPT/Modifier |
|---|---|
| Gastric Bypass for Morbid Obesity | 43846 81 |
Resources
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 20.4.3
- CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 26, Section 10.7
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