Michelle Posted Sun 26th of January, 2020 23:21:28 PM
My provider is going to start having a couple of patients come in every other week to do a capillary blood level test in the office for a medical assistant appointment. Do you know what billing codes can be used for a medical assistant appointment and capillary blood level test? The doctor will be supervising the provider and will sign off on the notes.
SuperCoder Answered Mon 27th of January, 2020 09:20:38 AM
Thank you for your question.
For capillary blood level test in the office use CPT 36416 (Collection of capillary blood specimen (eg, finger, heel, ear stick).
And for medical assistant appointment we can bill E/M codes depending upon documentation and whether patient is established or new with modifier GC (This service has been performed in part by a resident under the direction of a teaching physician).
Also, it should be clear assistant is intern or resident.
NOTE: we must identify teaching physician who involves residents in the care of your patients on claims. Claims must comply with requirements in the General Documentation Guidelines and E/M Documentation Guidelines sections. Claims must include the GC modifier, “This service has been performed in part by a resident under the direction of a teaching physician,” for each service, unless the service is furnished under the primary care exception.
Michelle Posted Mon 27th of January, 2020 10:41:01 AM
Are claims paid at a reduced rate with GC modifier? I know claims are reduced when billing a PA.
SuperCoder Answered Tue 28th of January, 2020 23:57:40 PM
Modifier -GC, is an informational code only and does not affect payment. It would be attached to the teaching physician's claim in the situation that the fellow performed part of the surgery/examination. (cannot be a "key" portion unless the teaching surgeon is physically present).
See two different scenarios below:
Teaching surgeon opened patient, performed the surgery, then fellow closed (with or without surgeon present) and your PA assisted,
Bill 12345-GC for teaching surgeon
12345-AS for PA assist
If your teaching surgeon was primary for everything and fellow was first assist, with PA 2nd assisting, bill 12345 (no modifier) for surgeon nothing for the assist since you cannot bill for the fellow and your PA was only 2nd assist.
Hope it helps.