Although the principal surgeon oversees the patient’s case, assistant surgeons may be necessary when the procedure or patient’s condition is complex. The assistant surgeon performs under the direct supervision of the principal surgeon and is often in the same specialty as the principal surgeon. Below are some tips to follow when utilizing an assistant surgeon.
Modifiers
| Notes | |
|---|---|
| 80 | Assistant Surgeon Assists the principal surgeon during the entire procedure |
| 81 | Minimum Assistant Surgeon Assists the principal surgeon during part of the procedure |
| 82 | Assistant Surgeon when qualified resident surgeon is not available Assists the principal surgeon during the entire procedure when a medical resident is not available to assist |
| AS | Assistant at surgery Used for assistant at surgery services that are provided by a Physician’s Assistant (PA), Nurse Practitioner (NP), or Clinical Nurse Specialist (CNS). Provider must accept assignment |
Status Indicators
| Notes | |
|---|---|
| 0 | Payment restriction for assistants at surgery applies to this procedure unless you send in supporting documentation to prove medical necessity. |
| 2 | Payment restriction for assistants at surgery do not apply to this procedure. Assistants at surgery may be paid. |
Documentation Tips
- The “assistant to surgery” provides more than just ancillary services. The operative note should clearly document the assistant surgeon’s role during the operative session.
- Documentation must provide a clinical picture of the patient and include:
- The procedures or services performed and support the use of modifiers 80, 81, 82 and AS
- The name of the assistant
- Evidence the assistant surgeon actively participated in the procedure (description or body of the op-report)
- Clearly document the assistant’s role during the operative session:
- Assistant’s role provides more than ancillary services
- Primary surgeons signature:
- The assistant is not required to sign the operative report, the primary surgeon’s signature is sufficient
- Modifier 82 requires the circumstance documented in the medical record that a resident surgeon was not available.
Notes:
- Only the AS modifier must be reported on the claim form when a NP or CNS bills assistant-at-surgery services
- Supporting documentation must be submitted at the time of claim submission to establish medical necessity and should clearly document the assistant surgeon’s role during the operative session.
