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Dec 8th, 2014 - assure6 4 

E/M service provided by a assistant surgeon

Hi,
Please could you let me know how to bill for an E/M service provided by an assistant surgeon ( M.D or D.O ) and primary physician. When the primary physician and assistant surgeon perform a surgery , we can bill for the assistant surgeon also by appending a modifier 82 to the surgery code. How do we bill for a E/M service provided by the assistant surgeon overseen by the primary surgeon.

Thanks in advance

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Dec 9th, 2014 - LBAROGIANIS 250 

re: E/M service provided by a assistant surgeon

If you are talking about a same day of service that the primary saw the patient and then the patient went to see the assistant surgeon. The primary would bill his code, ex: 99213, then the assistant surgeon would bill a consult code, ex: 99242. However, if the surgeon performed a procedure on the same day, then most likely it will deny. If the decision for surgery is decided on the consult, he would need to append modifier 57. But if your primary physician and assistant surgeon are in the same office, they both can't bill. Only one doctor would be allowed to bill. You can't double dip, however, it could be possible if they do not share the same tax id's.

Hope this helps.

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Dec 14th, 2014 - assure6 4 

re: E/M service provided by a assistant surgeon

thankyou very muchfor your reply, so it is understood that when both assistant surgeon and primary physician are in the same office, only the primary physician can bill for the E/M visit.

What if the patient did not see the primary physician at all and the consultation was done alone by the assistant surgeon? Please do let me know...
your feedback is much appreciated.

Thankyou

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Dec 15th, 2014 - LBAROGIANIS 250 

re: E/M service provided by a assistant surgeon

Check out the article here on Codapedia. Consultation services. Any doctor who saw the patient can bill for an E/M code. If the assistant surgeon is not in the same speciality, he can bill for a new patient or consultation. If they are in the same speciality, they can bill a follow up visit. I am assuming that the primary care has already billed a new patient visit and that can only be billed once in a 3 year period.

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Dec 15th, 2014 - luannw7     18 

re: E/M service provided by a assistant surgeon

What is the medical necessity for the assistant surgeon to be billing an E&M visit?

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