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Q&A Need help with modifier AS vs. 80

Fireflyhillary

New Member
Can someone please help me with when modifier AS should be used over modifier 80? I am actually watching the blitz videos & happen to be watching the modifier video right now, and on top of that, I am also trying to figure out a personal claim of mine. I know that we are supposed to use the CPT modifiers before we use a HCPCS modifier, unless the HCPCS modifier goes into greater detail. Well, I happened to have knee surgery on 10/18/13 & was looking through my claims last night on my health insurance company's website & noticed there was a claim for an Assistant Surgeon that was denied. I called the insurance company & they gave me the CPT code used & also the modifier used, which was AS & told me that the CPT code used does not cover an Assistant Surgeon, so I may be responsible for that bill. Imagine my horror when the amount was $3,700!!! I did research about the Assistant Surgeon because I had never even heard of this person or the office that they work at & looked through my coding books so I would be completely prepared when I spoke with the billing office. Thankfully I am not responsible for the charges as they are out of network & I was not informed of the AS & I did not sign any paperwork that stated they would be used & I may get a bill for it. So, now I am completely confused about when to use AS & when to use 80. Can anyone help? Thanks! o_O
 
AS is for a Non Physician assist and 80 is for a Physician assisted surgery. The non physician assistant was probably denied if this was considered a global surgery.
 
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