Help with assistant fee

willette

Networker
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ANY help would be greatly appreciated. My surgeon harvests veins for the cardiothoracic surgeon to perform the coronary bypasses. He does not dictate this and we only charge for assisting the cardiothoracic surgeon by appending modifier 80. My surgeon wants to know the codes for this and if he should dictate and how PA's and Tech's charges are billed. From what I can gather the rule is if a surgeon performs the graft procurement we add a modifier 80 to the 33510-33516 codes...does anyone know if the procurement needs a separate dictation and how is it billed for a PA (AS?) or hospital Tech? Again, greatly appreciated!:eek:
 

jewlz0879

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ANY help would be greatly appreciated. My surgeon harvests veins for the cardiothoracic surgeon to perform the coronary bypasses. He does not dictate this and we only charge for assisting the cardiothoracic surgeon by appending modifier 80. My surgeon wants to know the codes for this and if he should dictate and how PA's and Tech's charges are billed. From what I can gather the rule is if a surgeon performs the graft procurement we add a modifier 80 to the 33510-33516 codes...does anyone know if the procurement needs a separate dictation and how is it billed for a PA (AS?) or hospital Tech? Again, greatly appreciated!:eek:
He can bill for this; take a look at code 33508. Now, if he is going to bill for the Saphenous vein harvest (33508), he will need to make sure he dictates in the report that he (or a PA/Tech) endoscopically harvested this vein. He MUST state that it was done endoscopic in order to bill for 33508. He may also choose to utilize an upper extremity vein; take a look at 35500 for that. You can bill 33508 with an AS modifier as well.

So it doesn't need a separate dictated note, just make sure it is included in the original OP note.
 
Last edited:

willette

Networker
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Thanks Julie - I found out this cardio surgeon pays us separately for the harvesting of veins for him. I have to find out more but I cannot bill this code alone anyway because it is an add on code. We do bill for the assist on the graft codes with an 80 modifier. I think the other surgeon pays us because the reimbursement is so low. Still not sure why they do not dictate but if they are an assist, the primary surgeon does state that the harvesting was done but does not reference our surgeons. We are listed as the assists...does any of this make sense?
 
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