Wiki Modifier 80/ 82-Please help!

danilyn

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Hello i need some guidance on this issue we are currently having....

We are a teaching hospital that has a GME program. Our cardiac surgeons never involve residents in cardiac surgery. Does the assistant to the cardiac surgeon bill with an 80 modifier as long as there is an across the board policy that no resident would ever be utilized as the assistant to the cardiac case?

Or does the 82 modifier still need to be appended along with an attestation even though a resident will never be utilized?

I cannot find black and white information on this issue. Can someone please help me out? Does anyone out there have documentation on this? Thanks!! :confused:
 
As per my understanding, YES, the Assistant surgeon ( the assisting Surgeon at Surgery) will report with the modifier 80. The question of -82 does not apply to your cardiology department as per its policy/and institional policy, (as your cardiac surgeons Made it a "policy''.
This holds good with other subspecialties like Neurosurgery, renal transplant surgery cardiothoracic surgery etc
The bottom line is it is at the discretion of the specialty surgeons and policy to include the residents or not, into the system of surgeries. In such situations the 82 is not applicable.

Kindly read through the previous thread Modifier -62 and -66 and the postings therein. You will understand better.
Does this make sense? I think it is, very well.
 
It's one sentence ...

It's just one sentence ... how difficult is it for the surgeon to remember to state "no qualified resident available so Dr X assisted"? Do they want to get paid?

We do not allow any department to have a blanket policy that they won't use residents. If they want to bill the assist, they need the "no qualified resident" statement in their operative note, and we then use -82 modifier for the assistant surgeon.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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