Modifier 82

Assistant Surgeon - when qualified resident surgeon not available

Instructions

This modifier is used when minimal surgical assistance is needed, but a qualified resident was not available (documentation required). First, check Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor List. Column A indicates if assistant at surgery allowed/not allowed.

Correct Use

  • Physician:
    • Assist-at-surgery allowed with appended modifiers 80, 81 or 82
    • Allowed = 16% of surgery fee schedule allowable
  • Modifier 82 needs a statement that "no qualified resident surgeon was available"
    • Indicates exceptional medical circumstances exist
    • Primary surgeon must have a policy of never involving residents in preoperative, operative or postoperative care of his/her patients
  • Non Physician Practitioner (NPP) or mid-level practitioner (PA, NP, CNS):
    • Append AS modifier only
    • Allowed equals 85% of surgical assist or 16% allowable

Incorrect Use

  • Inappropriate to bill physician assistant surgical services with AS modifier
  • Inappropriate to append modifier 58 (staging) with any assistant surgery

Claim Coding Example

  • Per 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
Laparoscopy, surgical prostatectomy 55866 82

 

Resource

 

Last Updated Tue, 25 Oct 2022 15:38:57 +0000