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Thread: Disagree with Primary surgeon coding-opinions please

  1. #1

    Default Disagree with Primary surgeon coding-opinions please

    AAPC: Back to School

    My Doctor resently started assisting another surgeon. When I received the charges I didn't agree with them. I politely questioned the office manager ( who doesn't bill, code or post the charges) about who and how the codes were choosen. She stated that the doctor did the coding from the attestation statement from the hospital. I pointed out that the secondary code was CCI'd into the primary and that it really wasn't correct. Her response was "well he has always done it that way and we get paid". The hairs on the back of my neck stood up at that.
    I guess my questions are:
    1. Do I code the way he did, since we are the asst or code correctly and hope for the best?
    2. Am I legally held responsible in anyway?
    Any thoughts or comments would be appreciated.

    Tammy Hughes, CPC
    Tammy Hughes, CPC
    Practice Manager
    Richard M. Goddard, M.D
    Grass Valley CA

  2. #2
    Join Date
    Apr 2007
    Martinez, CA


    The surgeon I work for does assists and we have run into the same problem, at times, with the other surgeon's billing. My surgeon has told me to bill correctly, using the codes which I know are right and not the incorrect one. As he only gets about 20% of the total fee anyway, I guess he is more worried about accuracy. He also told me that often he will assist to learn a specific technique, so he considers that if he gets paid, it is a perk!
    I have also found out that if the other surgeon's office is getting the pre-certs from the insurance company, be sure they state that there will be an assistant. We have been burned a couple times, when the insurance company denies our claim, stating that the authorization did not have an assistant approved.

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