Forum - Questions & Answers

Aug 4th, 2011 - Jhartung

Two Assistant Surgeons

Is there a way to bill and be reimbursed for two assistant surgeons? One is a surgeon and the other is a PA.

Aug 5th, 2011 -

re: Two Assistant Surgeons

Yes, Indicators assigned by Centers for Medicare and Medicaid Services show if a specific modifier can be used with a CPT® code and how the modifier affects payment.

0 Payment restriction for assistants at surgery applies to this procedure unless
supporting documentation is submitted to establish medical necessity.

1 Statutory payment restriction for assistants at surgery applies to this
procedure. Assistant surgery may not be paid.

2 Payment restriction for assistants at surgery does not apply to this procedure.
Assistant surgery may be paid.

9 Concept does not apply

If the CPT® shows a 2 indicator a second assist can be billed and reimbursed but reimbursement is also based on the patient's individual insurance plan benefit guidelines. Always send OP report.

80 modifier would be used for the surgeon and AS for the physician assistant.

Aug 5th, 2011 - DebraS   67 

re: Two Assistant Surgeons

Physician
-62 When two surgeons work together as primary surgeons performing distinct part(s) of a procedure. Both physician's would use -62 on the same CPTs. Separate report by each physician required.

-80 Assistant surgeon: only the assist "surgeon" would use the -80 on the appropriate CPT®.

PA:
AS - Non-physician assist: would be used on the other CPTs that is not being used by the other modifier.

Only one assist per CPT® so up to the physician how he wants to bill out depending on the discription.



Home About Terms Privacy

innoviHealth® - 62 E 300 North, Spanish Fork, UT 84660 - Phone 801-770-4203 (9-5 Mountain)

Copyright © 2000-2024 innoviHealth Systems®, Inc. - CPT® copyright American Medical Association