Wiki Documentation needs for assistive surgery

[kathyyoung]

A podiatrist assisted surgery with a surgeon as the surgery was in part on the achilles. We billed with modifier 80. We were denied stating podiatrist could not assist. He is a podiatry surgeon and is diplomate board certified as a podiatric surgeon. Does he need to have his own OP report? He has only provided the primary surgeons report with his name listed. And can he assist?
Kathy Young CPC CPMA

 

[dclark7]

It depends on what the actual procedure code was and what the scope of practice is for your state. Many insurance companies have very limited definitions of what podiatrists can and cannot do, but most of the limitations are based on the state's scope of practice. You can usually find the scope of practice on your state's Dept of Public Health website (or whoever is the licensing body for providers in your state).