Modifier 82 describes using an assistant surgeon when a qualified resident surgeon is unavailable. In this article, we will provide a detailed explanation of modifier 82, including its definition, when to use it, documentation requirements, billing guidelines, common mistakes, related modifiers, and tips for medical coders.
1. What is Modifier 82?
Modifier 82 is an assistant surgeon modifier used in medical billing and coding to indicate that an assistant surgeon was necessary during a surgical procedure because a qualified resident surgeon was unavailable. The assistant surgeon performs under the direct supervision of the principal surgeon and is often in the same specialty as the principal surgeon.
2. When to use Modifier 82?
Modifier 82 should only be used when a qualified resident surgeon cannot assist with a surgical procedure. The assistant surgeon must document that a medical resident was unavailable to assist with the procedure. Other clinicians can assist with surgeries, but you should only use the Assistant Surgeon modifiers for physicians’ procedures.
The official description of Modifier 82 is “Assistant Surgeon (when the qualified resident surgeon is not available.)”
Examples of procedures that may require Modifier 82 include complex surgeries or surgeries on patients with complex medical conditions. The assistant surgeon may be necessary to assist the principal surgeon during the entire procedure when a qualified resident surgeon is unavailable.
To use Modifier 82, the assistant surgeon must document that a qualified resident surgeon was unavailable to assist with the procedure. This documentation should be included in the patient’s medical record and available for review by the payer if requested.
To bill for Modifier 82, the principal surgeon submits the procedure code for the surgery to the payer. The assistant surgeon submits the same procedure code with Modifier 82.
Medicare and many other payers require providers to obtain preauthorization for services and procedures before approving assistant surgeons’ claims for payment.
Payers also reimburse differently for assistant surgeons and minimum assistant surgeons, often paying a percentage of the total reimbursement amount for the procedure, with less paid to a minimum assistant surgeon than an assistant surgeon.
7. Common mistakes
Medical coders make common mistakes when using Modifier 82, including using it when a qualified resident surgeon was available, failing to document that a qualified resident surgeon was unavailable, and using it for procedures that do not require an assistant surgeon.
Medical coders should carefully review the patient’s medical record to avoid these mistakes and ensure that all documentation is complete and accurate.
8. Other modifiers related to Modifier 82
Other modifiers related to Modifier 82 include Modifier 80, which indicates that the assistant surgeon assisted the principal surgeon during the entire procedure, and Modifier 81, which indicates that the assistant surgeon assisted the principal surgeon during part of the procedure.
When using Modifier 82, medical coders should ensure that all documentation is complete and accurate and that the assistant surgeon has documented that a qualified resident surgeon was unavailable to assist with the procedure.
Medical coders should also know the preauthorization requirements and reimbursement guidelines for assistant surgeons.