Wiki TAVRS and surgical assists

[shainametz]

I have had issues getting payment for surgical assist claims for the TAVR procedures, CPT 33361 and 33362. The Medicare fee schedule designates status indicator 0, meaning the procedure is sometime reimbursed for an assist. Per Medicare manual these codes require -Q0 and -62. When billing a midlevel assist we are getting co-4 (invalid modifier) denials when we omit or append -62. Has anyone had any luck with getting the assistant surgeon paid from traditional Medicare? I spoke to a Medicare rep and she stated they don't reimburse midlevel assists for TAVR but she was unable to give me her reference... We have no appeal rights because of the CO-4 denial however all required information is on the claim, -Q0 and CT#

 

[ellis3350]

Hope this helps.

 

[vgriffin]

It is my understanding that when using a 62 modifier, no assistant is billable for the procedure code being billed with the 62.