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Assistant Surgeon

  1. Default Assistant Surgeon
    Medical Coding Books
    I was wondering what the proper documentation would be needed for an assistant surgeon (mod 80). Some of my providers just have a line in the beginning of their dictations that look like this...

    Assistant Surgeon: Dr. Name

    And then it says nothing ever again in the dictation about the use of the assistant. Is that appropriate or should there be something in the body of the documentation stating something about the assistant?

    Thanks much,

  2. #2
    Milwaukee WI
    Default Body of report must include HOW assisted
    The body of the report should include how the other surgeon assisted.
    For example: "Dr X assisted in this laparoscopic procedure, handling and monitoring the camera."

    Our compliance department HAS accepted documentation wherein the surgeon lists the assist a the top and then routinely uses "we" through the report. For example: "We made a 5-cm incision. We found X. We removed Y. We closed with bungee cords" (just want to be sure you're paying attention ...)

    But our surgeons are usually more specific in identifying HOW the assistant helped.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Wink
    I've been appealing our very wrongly denied assistant surgeons using information from the American College of Surgeons. Check out their website for a document that lists all the surgeries and the frequency of use for an assistant surgeon, in addition to information on who qualifies as an assistant surgeon.

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