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Ance surgeries incident to

Kathleen Posted Mon 07th of October, 2013 12:26:59 PM

We have aesthicians who do acne surgeries (10040) and they are billed incident to.

If a mid level sees the patient initially and establishes the patients plan of care, should the acne surgeries that are done by the aesthicians at another visit be billed under the mid level that initially saw the patient and established the plan of care?

I was just not sure if you can bill services incident to a mid level (PA) or if the provider always had to be a physician.


SuperCoder Answered Mon 07th of October, 2013 15:48:20 PM

According to the 2013 Coder's Desk Reference, only a Physician may perform the procedure '10040' and bill for it.

Kathleen Posted Mon 14th of October, 2013 08:55:46 AM

So you are saying that a physician or a mid level (PA) cannot have a licensed medical aesthician peform these services incident to?

SuperCoder Answered Mon 21st of October, 2013 18:29:30 PM

That's correct. A licensed medical aesthetician is not a recognized provider of services described by CPT which is used universally to report medical services. This includes CPT code '10040' If the aesthetician is working as a medical assistant, their services are bundled into the physicians payment and you'd follow the health plans' rules for supervision. There are no services that an aesthetician can legally perform (supervised or not) by the Medicare program because it requires a medical license to be a recognized provider. Most payers follow Medicare's lead. You have to be careful about her scope of practice.

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