82 - JF Part B
Assistant Surgeon - when qualified resident surgeon not available
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.
- 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
- 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.
|Laparoscopy, surgical prostatectomy||55866 82|
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 20.4.3
Last Updated Tue, 25 Oct 2022 15:36:48 +0000