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Physician Assistant Coding-Orthopedic

Samantha Posted Tue 19th of January, 2016 15:48:34 PM

Often in the operating room a resident will take a first assistant position and "our" physician assistant (not employed by the hospital) will take a second assist role. Can our physician assistant bill for this?
The logic is that if our physician assistant was not there one of the surgical techs would have to take his place and I would imagine the hospital bills for this.
Can our physician assistant bill for this instead? Please provide any reference,documentation to support your answer.

SuperCoder Answered Wed 20th of January, 2016 08:36:04 AM

When a non-physician provider (NPP) assists the surgeon, Medicare uses modifier AS to report nonphysician assistant-at-surgery services. Modifier AS represents 'Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery'.

However, if the PA is a physician/assistant surgeon, then modifier 80 is used to bill for the services.

Please see the following links for reference:

http://www.aaos.org/AAOSNow/2007/MarApr/managing/managing14/?ssopc=1

http://www.wpsmedicare.com/j8macpartb/resources/modifiers/assistsurgerymodifiers.shtml

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf
(Please see section 110.2 in this link)

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