Wiki podiatry surgical assistant

amatoj16

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I work for a podiatry office that specializes in Foot and Ankle surgeries. There are a few surgeries that might need an assistant. Could i bill for an assistant with a modifier 80 on it? The doctor thinks that insurances do not pay for assistants for podiatry . Does anyone know or have any experience in this since i am new to this practice.
 
In most CPT books the codes indicate if an assist is allowed with an -80 among other things. It's usually in a box. If it's not in your specific book check your encoder which you must have. There are a ton of NCCI edit conflicts with foot & ankle surgery, just the nature of the beast. If your assistant is a PA you will probably need to bill the modifier -AS instead.
 
I work for a podiatry office that specializes in Foot and Ankle surgeries. There are a few surgeries that might need an assistant. Could i bill for an assistant with a modifier 80 on it? The doctor thinks that insurances do not pay for assistants for podiatry . Does anyone know or have any experience in this since i am new to this practice.
I have attached a master list I have saved from UHC for payable codes for assistants, but you can obtain a complete list of CPT codes from your MAC provider's website. https://www.cms.gov/medicare/new-medicare-card/providers/macs-provider-portals-by-state.pdf

The 80 modifier only applies to an assistant surgeon that is a physician so if they are a healthcare professional (NP, PA, or CNS) the 'AS' modifier would be more appropriate.
 

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  • Assistant-at-Surgery ELIGIBLE LIST.pdf
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there are resources, Medicare being one, which will indicate whether or not an assistant is reimbursable for a given procedure.
having said that, 2 more points to make: I have never billed an assistant for Podiatry procedures. and Modifier 80 is assigned when the assistant is an MD.
modifier AS is assigned for PA assist.
 
I have attached a master list I have saved from UHC for payable codes for assistants, but you can obtain a complete list of CPT codes from your MAC provider's website. https://www.cms.gov/medicare/new-medicare-card/providers/macs-provider-portals-by-state.pdf

The 80 modifier only applies to an assistant surgeon that is a physician so if they are a healthcare professional (NP, PA, or CNS) the 'AS' modifier would be more appropriate.
Thank you so much!! great help.
 
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