Wiki billing for an NP who assisted in surgery

[blnord]

I am billing for a Nurse Practitioner who occassionally assists in surgery and have a few questions; in particular, I am resubmitting a claim to Medicare and on the original claim the previous biller billed the fees at the 20% of what the surgeon charged? Does this sound right? I was told that the assistant claim must match the surgeons claim, codes, fees etc...??? Im worried that if I bill at 20% of what the surgeon billed we'll only get paid 20% of that??

 

[FTessaBartels]

Same fee

We bill using the exact same codes/fees as for the primary surgeon. The payer will adjust according to the contract and we take the adjustment based on the EOB.

If you reduce the FEE you put on the claim, the payer may further reduce that because of the assist modifier.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[blnord]

Thank you, that's what I thought and I couldn't figure out why they would bill for the 20% and take the chance that they would pay less?? They also had 3 different place of service codes on the claim so that should have clued me in :/