Chapter 4.5. Division of Workers' Compensation
Subchapter 1. Administrative Director -Administrative Rules
Article 5.3. Official Medical Fee Schedule

§ 9789.16.8. Surgery - Assistants-at-Surgery.

For assistant-at-surgery services performed by physicians, the fee schedule amount equals 16 percent of the amount otherwise applicable for the surgical payment.

Procedures billed with the assistant-at-surgery physician modifiers -80, -81, -82, or the AS modifier for physician assistants, nurse practitioners and clinical nurse specialists, are subject to the assistant-at-surgery policy.

If the Assistant at Surgery ("Asst Surg") column of the National Physician Fee Schedule Relative Value File contains an indicator of "0" the physician or non-physician practitioner must submit documentation to establish medical necessity for use of an assistant at surgery. If the Assistant at Surgery column contains an indicator of "1", assistant-at-surgery is not payable. If the Assistant at Surgery column contains indicator "2", the assistant at surgery may be paid.

Payment is not generally allowed for an assistant surgeon when payment for either two surgeons (modifier "-62") or team surgeons (modifier "-66") is appropriate.

Note: Authority: Sections 133, 4603.5, 5307.1 and 5307.3, Labor Code. Reference: Sections 4600, 5307.1 and 5307.11, Labor Code.

HISTORY

1. New section filed 9-24-2013; operative 1-1-2014. Submitted to OAL as a file and print only pursuant to Government Code section 11340.9(g) (Register 2013, No. 39).