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Assistant surgeon payment for unlisted CPT?

Charlene Posted Fri 16th of August, 2019 13:16:33 PM
Hello, Can you point me to any guidelines regarding billing for assistant at surgery on unlisted procedures? I've searched, but am unable to find anything at present. I believe I've read that insurance may or may not reimburse assist on unlisted procedures. My current claim is specific to Medicare.
SuperCoder Answered Mon 19th of August, 2019 05:42:10 AM

According to the Medicare, Assistant at Surgery can be applicable for the procedures with fee schedule indicator "2". Which says, “Payment restriction for assistants at surgery does not apply to this procedure”. Assistant at surgery may be paid.

For example, with procedure for 22899 (Unlisted procedure, spine), modifier 80 (Assistant Surgeon) is applicable.

You can find CPT to modifier crosswalk on the SuperCoder and check all the modifiers applicability in respect to the procedure.

Hope this helps!

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