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Reimbursement and Medical Office Management Information
Reimbursement and Medical Office Management Information
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| Surgical Modifier 80 versus Modifier 82 - which one is your Surgeon? |
I know these two modifiers can be very confusing. Let me share to you on my blog what I know
based on my knowledge and experience what are these modifiers and how should we properly
utilize them based on medical necessity of the services performed by our providers.
Modifier 82 - (Assistant Surgeon) (when qualified resident surgeon not available) This modifier is
only used by providers who are in a Teaching Facility/Hospital. For instance, if there is no
"qualified" resident surgeon is available, and your Surgeon performed the procedure, your
surgeon becomes a Modifier 82!
** Documentation is based on the primary surgeon. It must be documented that no qualified
resident surgeon is available at that time of service.
Modifier 80 - (Assistant Surgeon) Is used for providers who assisted a procedure and are NOT in
a teaching facility/hospital.
**Documentation is based on the primary surgeon's operative report.
TIPS: Find out from your payors what are the procedural codes that are billable or eligible with an
"assist".
REFERENCE: Read More Information on "Teaching Facility Billing"
http://www.cms.gov/manuals/downloads/clm104c12.pdf
based on my knowledge and experience what are these modifiers and how should we properly
utilize them based on medical necessity of the services performed by our providers.
Modifier 82 - (Assistant Surgeon) (when qualified resident surgeon not available) This modifier is
only used by providers who are in a Teaching Facility/Hospital. For instance, if there is no
"qualified" resident surgeon is available, and your Surgeon performed the procedure, your
surgeon becomes a Modifier 82!
** Documentation is based on the primary surgeon. It must be documented that no qualified
resident surgeon is available at that time of service.
Modifier 80 - (Assistant Surgeon) Is used for providers who assisted a procedure and are NOT in
a teaching facility/hospital.
**Documentation is based on the primary surgeon's operative report.
TIPS: Find out from your payors what are the procedural codes that are billable or eligible with an
"assist".
REFERENCE: Read More Information on "Teaching Facility Billing"
http://www.cms.gov/manuals/downloads/clm104c12.pdf