tci General Surgery Coding Alert - 2014 Issue 7

Reader Question: Select Assistant Surgery Modifier For Your Case

Question: We just received a rejection for an assistant surgeon fee for an epigastric hernia repair (49572-80), although we’ve been paid in the past. How can I find out if modifier 80 is allowed with this procedure? SuperCoder Subscriber Answer: Code 49572 (Repair epigastric hernia [e.g., preperitoneal fat]; incarcerated or strangulated) is billable with modifier 80 (Assistant surgeon). You can look at the Medicare physician fee schedule data base column for “Asst Surg” or use a look-up tool such as SuperCoder to see what modifiers are allowed with a specific code.  However, even if the...

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