Wiki Certified Surgical Technican Billing as 81 mod.

[anita carleton]

Does anyone know if a certified surgical technican is considered an "allied healthcare professional"? I am asking this due to a doctor wanting to bill his CST to assist in surgery using an 81 modifier. Does ot the allied individual have to be at least an RN? Is this appropriate to do?

Thanks for you help!!

 

[LLovett]

I don't know if this varies from state to state payer to payer but as far as I know CMS will not cover surgical techs as surgical assistants.

In my experience working in Michigan, Ohio, and West Virginia this is not appropriate.

The other thing to consider it does the CST work for the physician or the facility?

Regardless of whether or not they can be billed, if they don't work for the physician it is not an option at all, their cost is built in to the facility fee.

Hope this is even remotely helpful,

Laura, CPC, CEMC

 

[anita carleton]

The CST works for the physician. He would be bringing that person along with him. I know the hospital normally staffs the facility were they are rendering services as that is part of the facility fee. For ex. OR level I, II or III. Dependant on the staff. I appreciate your help. Not an easy question. This is a workers comp case. So no Medicare but we do have a state fee schedule that does not want to answer this question either!! Thank you so much.