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PA assisting surgeon

  1. Default PA assisting surgeon
    Medical Coding Books
    I am billing for a PA who is assisting with several different surgeons from different practices. I was told I need to bill the same charges as the physician bills. One of our physician's is concerned about this violating the Stark Law. Does anyone know if this is something I need to be concerned about?

  2. #2
    Location
    Milwaukee WI
    Posts
    4,466
    Default Assist
    Whether it is a PA, an NP, or another physician who is assisting, you always use the same code the primary surgeon uses, with the appropriate assist modifier.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Default
    PA ,nurse practioner ,or clinical nurse specialist services for assistant at surgery will be
    AS attached to the code for surgery.
    A few years ago it was same as for asst Surgeon -80. but not now

  4. #4
    Location
    North Carolina
    Posts
    3,126
    Default
    Quote Originally Posted by ssmith24 View Post
    I am billing for a PA who is assisting with several different surgeons from different practices. I was told I need to bill the same charges as the physician bills. One of our physician's is concerned about this violating the Stark Law. Does anyone know if this is something I need to be concerned about?
    Are you speaking of reporting the exact same fee? Carriers vary but Medicare reimburses 16% of the allowable for an assistant PA. Reporting the exact same fee would increase your adjustments...

    20.4.3 - Assistant at Surgery Services
    (Rev. 1, 10-01-03)
    B3-15044

    "For assistant at surgery services performed by physicians, the fee schedule amount equals 16 percent of the amount otherwise applicable for the global surgery."

    https://www.cms.gov/manuals/downloads/clm104c12.pdf

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