Wiki Modifiers on Bilateral / Assist

[bmeech]

I can not seem to find any information on how the Assist. Surgeon / PA (80 or AS) should be billed as to the "Order of the Modifiers" during a Bilateral procedure.

Ex: Total Knee Replacement 27447-50 (primary procedure)
27447-AS or
27447-50-AS or
27447-AS-50, or
27447-AS-RT / 27447-AS-LT.

Due to the $ amount billed is adjusted, when billing 27447-AS Ins is only paying for the 1x procedure, rather then the Bilateral on the primary procedure, is not taken into consideration.

Looking for any suggestions / guidelines
Thanks
Brenda L Meech, CPC

 

[kelly.armstrong]

Brenda, I do coding for 3 orthopaedic surgeons. I have come across this many times. You would code the Assistant Surgeon as:

27447-AS-50

If you are only billing 27447-AS, the insurance doesn't know it is bilateral so you must use the 50 modifier.

Kelly Armstrong, CPC