Medical Billing and Coding Resources
A strong understanding of various codes that surgery treatments comprise of is required to be able to successfully bill the claims. It is important for practices to bring in reliable and expert vendors to handle billing, to overcome unique surgery billing challenges. Outsourcing surgery billing services can reduce practices’ overhead costs, increase reimbursements, decrease claim denials, and rejections. This can enable practices to focus more on their patients rather than spending hours constructing and interpreting the billing reports.
Split Surgical Care There are occasions when more than one physician may furnish aspects of the services included in the global surgical package. When different physicians of a group practice participate in the care of the surgical patient, the group practice bills for the entire global surgical package. The physician who performs the surgery is […]
Split Surgical Care There are occasions when more than one physician may furnish aspects of the services included in the global surgical package. When different physicians of a group practice participate in the care of the surgical patient, the group practice bills for the entire global surgical package. The physician who performs the surgery is […]
Split Surgical Care There are occasions when more than one physician may furnish aspects of the services included in the global surgical package. When different physicians of a group practice participate in the care of the surgical patient, the group practice bills for the entire global surgical package. The physician who performs the surgery is […]
Assistant at Surgery An ‘assistant at surgery’ is a physician/non-physician practitioner (NPP) who actively assists the physician in performing a surgical procedure. The ‘assistant at surgery’ provides more than just ancillary services. Documentation for an assistant at surgery services includes helpful information to assist providers inappropriately documenting medical necessity for assistant-at-surgery services. Now let’s look […]
Modifier AS: Non-physician Assisting at Surgery Medicare has established the AS modifier to report Physician Assistant (PA), Nurse Practitioner (NP), or Clinical Nurse Specialist (CNS) services for assistant-at-surgery, non-team member. Therefore, for Medicare reporting purposes and as directed by a commercial third-party payor, to indicate PA, NP, or CNS services for assistant-at-surgery, ‘AS’ would be […]
Modifier 82: Assistant Surgeon (when qualified resident surgeon not available) In certain programs or facilities (e.g., in teaching hospitals), the physician who generally acts as the assistant surgeon is a qualified resident surgeon. There may be times when a qualified resident surgeon is not available to assist the operating surgeon, so a physician assists the […]
Modifier 81: Minimum Assistant Surgeon Although a primary operating physician may plan to perform a surgical procedure alone, during the operation circumstances can arise requiring the services of an assistant surgeon for a relatively short time. In this instance, the second surgeon provides minimal assistance, for which he or she reports the surgical procedure code […]
Modifier 80: Assistant Surgeon During certain operations, one physician assists another physician in performing a procedure. The physician who assists the operating surgeon would report the same surgical procedure as the operating surgeon. The assistant surgeon generally is present during the entire operation or a substantial portion of the operation to provide assistance to the […]
Modifier 53: Discontinued Procedures As per Appendix A of CPT: ‘Due to extenuating circumstances or those that threaten the well-being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. This circumstance may be reported by adding the modifier 53 to the code reported by the […]
Modifier 66: Team Surgery Under some circumstances, highly complex procedures (requiring the concomitant services of several physicians or other qualified health care professionals, often of different specialties, plus other highly skilled, specially trained personnel, various types of complex equipment) are carried out under the ‘surgical team’ concept. Such circumstances may be identified by each participating […]
