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Acl recon and unicompartment

  1. #1
    Default Acl recon and unicompartment
    Medical Coding Books
    I have a patient that had an ACL reconstruction done arthroscopically with medial meniscectomy by one of our physicians and his PA. Then under same anesthetic patient was turned over to our TKA spcecialist who proceeded to do a unicompartmental knee and notchplasty to the same knee. I am not for sure why all procedures were not just done by one of the physicians but my question is can I charge for each physician services separately? Would this require a surgeon modifier? I didn't think it would since neither of them assisted the other but rather they each used their own PA for assistance. My thoughts are: Dr A: 27446-RT, 20985; and Dr B 29888-RT, 29881-51 on separate claims.


    Any thoughts would be greatly appreciated

    Vicki

  2. Default
    Quote Originally Posted by vmassey View Post
    I have a patient that had an ACL reconstruction done arthroscopically with medial meniscectomy by one of our physicians and his PA. Then under same anesthetic patient was turned over to our TKA spcecialist who proceeded to do a unicompartmental knee and notchplasty to the same knee. I am not for sure why all procedures were not just done by one of the physicians but my question is can I charge for each physician services separately? Would this require a surgeon modifier? I didn't think it would since neither of them assisted the other but rather they each used their own PA for assistance. My thoughts are: Dr A: 27446-RT, 20985; and Dr B 29888-RT, 29881-51 on separate claims.


    Any thoughts would be greatly appreciated

    Vicki

    Yes, you would bill separate because both physicians did separate procedures.
    Also, if you have to bill for the PA then you would bill the procedure code or codes that the PA assisted on and use AS modifier or 80 or 82 modifier if done in a teaching hospital.

  3. #3
    Default
    That is what I thought...thanks for reassuring my thinking! Have a great Friday

    Vicki

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