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Wiki Assistant Surgeons

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ABayless0900

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Brownsburg, IN
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If an assistant surgeon is the assisting on a procedure where the CPT code is an add-on code, and did not assist on the primary procedure.....how is this to be billed? We are seeing denials on the add-on code because the primary procedure wasn't reported by the Assistant, only the primary provider.
 
I don't know of any written guidelines for this situation. You may want to try a written appeal explaining the situation and why the base code can't be billed. Alternatively, you could bill the base code with a $0.00 or $0.01 charge just to get it to bypass the edit in the payer's system, as long as there was no other provider assisting at that procedure for whom this would create a duplicate claim.
 
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