# AS/UD Modifier



## bsievering (Oct 18, 2017)

New to PA billing for assisting in surgeries. Have done some research, but found contradicting answers.

I bill physician billing, not facility billing.

1st Question: Difference in AS and 80 modifiers? I see the definitions in the CPT book, but a few examples may make these make a little more sense.

2nd Question: Would we send separate claims to the insurance company? The first for the physician under his NPI, the second for the PA under her NPI - with the AS or 80 modifier?

The research my supervisor and I have done lead us to believe that we will need separate claims for each provider, but there has been disagreement among superiors.


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## csperoni (Oct 19, 2017)

1. -AS vs -80.  AS is specifically for "Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery" so PA, NP or RN specialist -80 is for "assistant surgeon", so MD or DO.  It is simply based on whichever type of practitioner assisted.
2.  Yes, separate claims for each provider.  
If your surgery code is 58150 with Dr. A primary and PA B assisting, you bill for:
58150 Dr. A
58150-AS PA B
Every once in awhile, you will run across a carrier that wants something different.  Some carriers (good example is GHI) want the PA claim billed under the supervising physician, so you would bill 58150 Dr. A and 58150-AS Dr. A.  One of the Medicaid carriers (can't recall who) wants the claim billed ONLY as 58150-AS Dr. A and will pay additional all at once.  That is definitely not correct, but the only way we can get paid for the assist.


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## bsievering (Oct 25, 2017)

*Thanks!*



cms@islandoncology.com said:


> 1. -AS vs -80.  AS is specifically for "Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery" so PA, NP or RN specialist -80 is for "assistant surgeon", so MD or DO.  It is simply based on whichever type of practitioner assisted.
> 2.  Yes, separate claims for each provider.
> If your surgery code is 58150 with Dr. A primary and PA B assisting, you bill for:
> 58150 Dr. A
> ...



Thank you so much! You're a huge help!


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## jackieeyder@hotmail.com (Oct 31, 2017)

*AS modifier*

I'm new to teaching hospital coding.  We bill lots of ortho codes for PA with modifier AS when they are assisting the surgeon but I've been told not to use laterality codes with mod AS. Is this information correct? Any help will be appreciated. Thanks


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## csperoni (Oct 31, 2017)

I've never coded ortho, which I am certain does require a lot of laterality modifiers.  If I was using those additional modifiers, I would make sure to use the -AS primary.  I always bill the PA assist claim identical to the primary surgeon with the -AS first.  So if I was billing for example, 58661-50 (bilateral) on the surgeon, I bill 58661-AS-50 for the PA.


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## pravintc (Mar 23, 2018)

One more scenario, the physician is performing multiple procedures with PA in attendance, in one surgery for increased procedural service we are applying modifier 22, do we need to append modifier 22 for the PA too and can we append all modifiers to PA (e.g. LT, RT, 51, 52, 59...)

Please reply.


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