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Curiosity..how does your clinic...

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1073358

Expert
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454
Location
Merrill, WI
bill for surgical assists? What I mean is how exactly do you determine what you bill for them? I am trying to improve our work flow and am curious how other's do this most efficiently. Does each hand in a charge ticket with what they did? Are you just billing same codes as surgeon if Medicare allows an assist?
 
Is your assist a PA or MD?

Either way, you would bill same codes as surgeon with modifier AS for PA or 80 for MD. Some payers don't recognize AS for PA's and use 80 for both PA's and MD's.

Your documentation should reflect that there was an assist present and what parts if not all they assisted in.

Normally, the physician surgeon will check or write in who the PA or MD was...the assists don't do seperate charge tickets.

Our cardiothoracic docs have a PA assisting every single time they do surgery, so for us, it's easy to know because Dr. A always has PA Jane and Dr. B always has PA Doe.
 
We code from the op report

We are a hospital-based practice, so we get the OR log each day. We then code from the actual op report. (We don't use superbills for surgery, but our surgeons, each keep a log book - or keep a log in their palm pilot if they are techno savvy - and our admin assistants reconcile the log books against the invoice records monthly to ensure we've captured all charges.)

The surgeon should clearly dictate the Assistant Surgeon (even if this is a PA) and what/how that person assisted. We'd code the identical CPT procedure with 82 modifier (we're a teaching hospital). If you are NOT a teaching hospital you would use 80 modifier. Our billing software has edits in place that will then change this to AS on the claim, depending on the carrier and PA acting as assist.

If Surgeon "A" states "Co Surgeon: Dr X" then we go looking for a separate op report from Dr X (who should state on his report "Co Surgeon: Dr A") We'd code the identical CPT procedure code for each surgeon with -62 modifier on each.

F Tessa Bartels, CPC, CPC-E/M
 
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