Urology Coding Alert

Question: Is there a difference in the reimbursement of procedures for modifiers 80 (Assistant surgeon) and 82 (Assistant surgeon [when qualified resident surgeon not available])?

Texas Subscriber

Answer: No, but your payer may ask for proof that there was no resident available when you use 82. And if they do not feel an assistant was warranted for the procedure code, you may not receive reimbursement at all.

Good advice: Always check to see if the procedure code allows for an assistant, and if it does and you are using 82, make sure you have the documentation ready to show that no resident was available. The surgeon should always list who the assistant surgeon is in his operative report, and indicate why the resident has been replaced as the assistant surgeon by a non-resident attending physician on this particular operative procedure.

The assistant usually is not required to dictate an operative report for himself. However, if the assistant surgeon assists at a procedure that will be coded as an unlisted surgical procedure, the assistant may want to dictate a short operative report as to what he did just as the primary surgeon will dictate his report for the unlisted surgery code billed.