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2 Assistant surgeons???

  1. #1
    Adirondack Chapter of Professional Coders, Glens Falls, NY
    Question 2 Assistant surgeons???
    Medical Coding Books
    Can someone help me? The doctor I work for is a plastic surgeon and he often assists other plastic surgeons with breast reconstructions and other extensive surgeries. He recently hired a PA to work with him in the OR, and he assisted another surgeon with a surgery and the PA assisted as well. He wants to know if there is a way to be reimbursed for his assistant claim and for his PA assisting as well. I know you would normally use modifier AS for a PA assisting, but in this case, would insurances reimburse for both an assistant surgeon AND an assistant PA?

  2. Default
    We have physician assistants as well, I would not recomend billing for the PA and the surgeon assisting on the same case, the insurance companies will rightly say to you how much extra help could the PA be in this case. If two dr's were able to do the surgery there really should be no need for the PA too unless it is a very unusual out of the ordinary extreme case. The services have to be considered medically necessary and appropriate not simply billed just to get payment. You might get a lot of red flags billing for 3 providers on the same case.

  3. #3
    I have come across a similar scenario. I work for OB/GYN docs who often assist each other in deliveries and surgeries, but the assistant never writes a note. They seem to think that they can try to bill without a note as long as they are stated or listed as assistant in the Surgeons note. Does anyone know the documentation guidelines for modifier 80? I am NOT going to bill for something that isnt documented.

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