# modifier AS



## kc-george (Feb 24, 2012)

Can anyone tell me, when you bill out a modifier AS for an assist at surgery, do I apply that modifier to the main procedure, and key it only once, or does it need to be keyed twice, once under the assist with the mod AS, and then under the doc with a different modifier?  Thanks... something new our practice is looking in to.


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## mhstrauss (Feb 24, 2012)

You should bill the surgery code (no modifier needed) for the primary surgeron, and then the same surgery code with the AS modifier for the assistant surgeon.


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## kc-george (Feb 24, 2012)

Thank you!  This is what I needed.


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## andersont (Feb 24, 2012)

*AS modifier*

Isn't AS modifier for physician assistant, nurse practitioner or clinical nurse. Mod. 80 would be used otherwise.


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## mhstrauss (Feb 24, 2012)

andersont said:


> Isn't AS modifier for physician assistant, nurse practitioner or clinical nurse. Mod. 80 would be used otherwise.



This is very true, andersont, thanks for pointing it out.  I assumed that the original poster meant the question was directed to a physician assistant, but that might not be the case.


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## mmpratt (Feb 25, 2012)

Just a quick note on modifiers.  Noridian Medicare is now enforcing a rule for PAs as assistants since January, 2012.

I used to add AS to the assist.  Now they require AS and 81 for PA assists.  If another MD assists, then you need AS and 80.  Noridian says this is not a new rule but is simply being enforced now.


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## jk2003 (Feb 27, 2012)

AS is used for Medicare when a physician assistant, nurse practitioner or clinical nurse assists.  Depending on the other carriers, use modifier 80 (assistant surgeon) and/or in addition to AS.  
Use modifier 80 if a second surgeon serves as an assistant.   
Use 82 if and when a qualified resident is not available (GMA program) and another surgeon/PA assists.
81 is used minimum assistant.


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## kc-george (Feb 29, 2012)

Yes, I was actually needing info as an NP will be the assist, so this helps!  Thanks everyone.  Does anyone have any more feed back about appending the modifier 80 as well for certain payers?  That one is new to me!  Also, if I am billing out a 29822; would I put MOD RT/LT primary, or AS?

Thanks so much everyone for this helpful feedback!!!


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## sadieandbrian (Jun 6, 2012)

Have you figured out how to bill an NP as the assist yet? We have tried both ways...AS-81, and just the 81 alone, because if you read the MCR update, it actually states just for "physicians assistants", doesn't actually say for any assists. Regardless, we've been denied both ways. Very frustrating.(https://www.noridianmedicare.com/cg...n&tmpl=part_b_viewnews&style=part_ab_viewnews)


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