Wiki Modifier 82 - This questions has come up

[dvance4210]

This questions has come up time and time again...can someone please point me in the right direction for an answer!

Modifier 82 is for an assistant surgeon (when a qualified resident surgeon is not available)the key word is available. Does that mean that this is used for a teaching hospital and when there is not a resident surgeon "available" it can be used? We are at a hospital where there are no resident surgeons at our facility, so I've have not used this code.

I have had this modifier interpreted both ways. Any clarification would be helpful!

Thanks,
Dorinda

 

[aaron.lucas]

You are right in your interpretation, -82 is used by teaching hospitals, where residents typically assist. Because (from what I understand) residents don't actually get paid per service, I believe it's a flat salary, they don't do any billing. If there is no resident available though, then someone who would bill per service would have to step in, so -82 is there to report this. If there was no -82 and you got a bill for an assistant that works at a teaching hospital, you would probably assume they are a resident, right? And you wouldn't pay it because the residents are supposed to bill. Make sense?

 

[dvance4210]

That's the way I understood it as well. We do not have resident surgeons available, so I didn't think that we should be using 82 at all (I normally use 80 for an MD and AS for our PA when he assists). Another office stated that they use the 82 because they do not get paid for an 80 modifier. That wasn't the way I thought the modifier was to be used.

Do you have any article or better documentations for this by chance?

I really appreciated your input!! I'm going to Chicago for the regional meeting, maybe that's a good question to ask them.

Dorinda V

 

[jettagirlfl]

Medicare-teaching facility----

I was told at the teaching hospital I work at, if this a Medicare patient, you must make sure the DR states a resident was not available at time of procedure, then the assistant use a 82

 

[aaron.lucas]

Unfortunately no I don't have anything in writing. I actually learned this at an all day Modifier training seminar given by AAPC. I'm sure there's probably something in the CMS policy manual, or maybe in the CPT Assistant? The other office may not be getting paid for the 80 because of bad documentation or because the procedures don't require an assistant. Yeah I would definitely ask at the conference if you get a chance, cool that you're going, hope you learn a lot!