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Thread: Assistant and add-on code

  1. #1

    Question Assistant and add-on code

    AAPC: Back to School
    I need help. Does anyone have an idea how to bill the following scenario? Surgeon A is doing a mitral valve replacement(33430), Surgeon B, also a cardiac surgeon scrubs in and performs a Maze procedure during the same operative session. I can’t bill the add-on code for Surgeon B. Can Surgeon B bill 33256 even though it’s the same session as Mitral valve procedure? Would I use the unlisted code for this and send notes? Any help is greatly appreciated.
    Last edited by toizd; 11-20-2009 at 06:43 AM.

  2. #2


    I would bill 33256 with a -52 modifier and send notes.

  3. #3


    I thought about that but they are same specialty, same group so technically they are seen as the same surgeon during the same session. this is a tricky one. Do you think because 33259 would only be reported with the more extensive procedure the assistant could be seen as an assistant for the whole operation? soemthing like 33430-82, 33259? or 33430-82,33259-82?

  4. #4


    If Surgeon A was present for the entire procedure, I personally think he should document the entire case (he can state in the note that Surgeon B performed the Maze) and then I would bill the entire case under Surgeon A.

    Like you said, they're in the same practice so they are essentially the same surgeon. I don't think your payer will want to pay anything additional for Surgeon B when Surgeon A could have done the whole procedure alone.

    Lisi, CPC

  5. #5


    I know this is an older post, but since I often refer to the archives, myself, I thought I'd add my two cents to this: I would bill the primary procedure with the -82 modifier (-80 if not in a teaching hospital). The physician who performed the MAZE should get credit for work performed.

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