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Assistants at Surgery at Teaching Hospitals

CMS has instructed providers to use specific modifiers on claims representing assistance during a surgical procedure:

  • Modifier 80 denotes service by an assistant surgeon
  • Modifier 82 denotes service by an assistant surgeon at a teaching hospital, in a situation in which no qualified surgical resident was available to assist

When a GME-approved surgical residency program exists at a teaching hospital, CMS expects that a qualified surgical resident will perform the role of surgical assistant during most, if not all, surgical procedures. Use of the 82 modifier requires documentation in the associated medical record, supporting the reason that a qualified surgical resident was unavailable to perform this service.

CMS provides an exception to this rule for attending surgeons at teaching hospitals who have established a uniform practice of excluding qualified residents from participation in preoperative, intraoperative and postoperative care for their patients. CMS article MM6123 provides further details on this issue.

When this exceptional circumstance occurs, the surgeon who maintains this across-the-board policy of excluding qualified residents from participation must file a statement to that effect at each teaching hospital at which he/she elects to maintain this policy. This statement must be updated by the surgeon annually and be available to submit to Medicare in the event of an audit of claims for surgical assistance occurring at that hospital.

Assistants at Surgery at Teaching Hospitals
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