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Thread: How do you determine if an assistant is allowed?

  1. #1

    Default How do you determine if an assistant is allowed?

    AAPC: Back to School
    I know CMS has guidelines which state if an assist is allowed, sometimes allowed or not allowed. Is there another source I can use for my physicians who say "This isn't a medicare patient so bill an assistant." 95% of the time the assist is denied and we have to file a pointless appeal.

    If you know of a resource other than CMS, please let me know.

    I look forward to seeing everyone in Long Beach.

  2. #2


    If you have your RVU file from the Federal Register, you should look at column AA. If you see a number 2 listed in this column, an assistant is allowed.


  3. #3

    Default Assist Guidelines


    Most Insurance companies follow NCCI guidelines on Assists. They also publish the policy. I would call your provider rep if you can't find it on thier webiste.

    Hope that helps


  4. #4

    Default Good Morning

    Just to let you know where I work we use Encoder Pro and it is a wonderful tool for coders. Not only does it list if an assistant can be use with a cpt code, it also gives rules and regulations from medicare and other helpful hints with your coding.

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