Wiki Endoscopic Vein Harvest

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kallenn

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When you bill the 33508, do you only bill it under the primary surgeon or the PA/2nd surgeon who did it?

Thanks,
K. Allen, CPC
 
I bill it under whoever did it. Which is usually the PA, and in that case I bill it with out the AS,80 modifiers.

Laura, CPC
 
I bill it under the primary surgeon because its an add-on code and needs to be billed with the primary CABG codes. In addition, if you're adding the -80 modifier, then you're indicating the PA was assisting and in that case, you should also be billing for the primary surgeon anyway.

Lisi, CPC
 
vein harvesting

Lisi,- my physician dictates in his op note that the NP did the vein harvesting, that is the only place she is mentioned in the notes. I do not bill for her because it is an add on code, nor do I bill for him because he specifies that she did the procedure. What documentation does your physician give you for the vein harvesting. I have been struggling with this.

Lillian. CPC
 
I always bill it under the primary surgeon that did the procedure as well as the assistant (with an 80 modifier) who helped on the case and I have no problems getting paid.
 
Lilian, my surgeon never specifically says who harvested the vein. I'm at a teaching facility so more times than not, its a resident who is doing the harvest. I just bill it all under the attending physician - the CABG codes and the EVH. I would probably do the same if it was a PA who did the harvest.

Lisi
 
Interesting information from WPSmedicare yesterday. We had a question into them on this topic, unfortunately they have 45 days to respond.

A rep from there called yesterday and stated that the endoscopic code should be billed under the surgeon and if the documentation supports the PA/NP involvement, it is also billed under them with the appropriate modifiers. We have requested this information in writing, but I wanted to post what I had at this point.

Laura, CPC
 
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