Description
Submit HCPCS modifier AS to identify the services of a physician assistant, nurse practitioner, or clinical nurse specialist for assistant at surgery.

Guidelines/Instructions

  • Submit HCPCS modifier AS to identify the services of a surgical assistant
  • Supporting documentation describing the medical necessity for an assistant must be submitted with the claim for services that have Asst Surg Indicator 0 in the MPFSDB

In addition, the following documentation is required in the medical record when the surgery is performed in a teaching hospital:

  • A statement that no qualified resident was available to perform the service 
  • A statement indicating that exceptional medical circumstances exist
  • A statement indicating the primary surgeon has an across-the-board policy of never involving residents in the preoperative, operative or postoperative care of his/her patients

To determine whether the services of an assistant may be submitted to Medicare with CPT modifier AS, refer to the Medicare Physician Fee Schedule database (MPFSDB):

  • Access the database directly from the CMS website
  • Select Physician Fee Schedule Search from the left area of the web page
  • Screen defaults to current year. Under "Type of Information," select Payment Policy Indicators, then Next
  • On the "Select Field Options" screen, select Next
  • Enter the procedure code and select All Modifiers, then click Submit
  • Refer to the column heading "Asst Surg"
  • Indicator 0 = Payment restriction for assistants at surgery applies to this procedure. Supporting documentation describing the medical necessity for an assistant must be submitted with the claim.
  • Indicator 1 = Statutory payment restriction for assistants as surgery applies to this procedure. Assistants at surgery will not be paid.
  • Indicator 2 = Payment restriction for assistants at surgery does not apply to this procedure. Assistants at surgery may be paid.
  • Indicator 9 = Concept does not apply (the most likely explanation is that the procedure is not a surgery)
References

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department



spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer spacer