Wiki Modifier 80 documentation

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stephmhut

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I work for OB/GYN docs who often assist each other in deliveries and surgeries. They seem to think that as long as they are just 'assisting' they dont need to write any sort of OP note or document what they did. I dont feel comfortable coding and billing for something that is NOT DOCUMENTED. Any suggestions? Does anyone know documentation guidelines for modifier 80?:(
 
stephmhut said:
I work for OB/GYN docs who often assist each other in deliveries and surgeries. They seem to think that as long as they are just 'assisting' they dont need to write any sort of OP note or document what they did. I dont feel comfortable coding and billing for something that is NOT DOCUMENTED. Any suggestions? Does anyone know documentation guidelines for modifier 80?:(
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We bill a lot of surgeries with assistant charges. We have only one op report that states who was the assistan and that he/she was present and scrubbed for the entire procedure and assisted the Dr throughout the procedure. I dont know if there is any special rules, but we never had any problems with medicare or any other payor.
 
We bill for assistants and do not have the assistant dictate anything separate. The OR indicates that there was an assistant and who it was and at the end of the OR, the primary surgeons dictates that the assistant was present for the entire procedure and assisted with suction, irrigation, instrumentation, etc. We as well do not have problems with any of our payors.
 
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