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Assistant Surgeon is DPM as well- how to get him paid?

C

caitlin.ski2011@gmail.com

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23
Location
Colorado Springs, CO
Good morning! We have a fellow at our practice (Sports Medicine) who is fully licensed as a DPM prior to coming to us. He is employed with our company under the full medical licensure rather than under a training licensure. He works with our primary DPM and is the assistant surgeon for the surgeries. There is discrepancies on how and if we can bill him as the assistant surgeon and get him paid for the work he is doing. We are in Texas if that matters. Can anyone direct me to the policies I need? Or if anyone has experience with this and let me know how you bill for the services? Thank you very much!
 
Good morning Caitlin! There is nothing special you need to do. Simply submit 2 claims. Once for the primary surgeon and the second for the assistant adding the 80 modifier to each line. Every CPT code has an "assist" added to it, and depending on what source you are using, such as apmacrc or the cpt coding books, the assist will either have a "Y" or a "N". The Y indicates an assistant will get paid, albeit much lower than the primary, but still gets paid.
 
Just don't forget to credential the provider!! I have a similar situation where each year we have a 1 year pelvic surgery fellow in a non-approved fellowship, who is a licensed ob/gyn. We have to credential the new fellow each year. When possible, I start insurance credentialing 2-3 MONTHS PRIOR to their start date.
 
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