DecisionHealth, DecisionHealth - 2012 Issue 7 (July)

Ask surgeons to substantiate need for assistants to avoid denials

A brief explanation of the surgeon’s need for an assistant could secure reimbursement and dodge denials for assistant surgery, which are on the rise. Modifier 80 (Assistant surgeon) was the top denied modifier in 2010, based on a Part B News analysis of Medicare claims (PBN 5/7/12). The denial rates rose to 20.9% in 2010 from 18.9% in 2009.

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