Don't have a TCI SuperCoder account yet? Become a Member >>

Regular Price: $24.95

Ask An Expert Starting at $24.95

Have a medical coding or compliance question? Don’t sacrifice your valuable time to endless research. Choose Ask an Expert to get clear answers from the TCI SuperCoder team. And here’s a tip for the budget-conscious: Select the 12-question pack to get the best rate per question!

Browse Past Questions By Specialty

+View all

E&M - Fibrinolytic Instillation - BY SEPARATE PROVIDERS

Kathy Posted Tue 31st of January, 2017 17:49:25 PM
Please give me your EXPERT opinion regarding the following scenario. Please provide your resources, if applicable. A patient is seen and MD performs & documents the components of an E&M service. It is determined the patient would benefit from fibrinolytic instillation and REQUESTS THIS PROCEDURE TO BE PERFORMED by a Certified Physician's Assistant or OTHER provider Thank you.
SuperCoder Answered Wed 01st of February, 2017 08:26:23 AM

Hi,

 

Considering your scenario as:

If your provider was providing the supervision, and the procedure was performed by the certified Physician's Assistant, then per coding prospective; appropriate codes would be, E/M code with 25 modifier along with procedure code of (fibrinolytic instillation), with modifier AS (Physician assistant).

 

If your provider is not providing the supervision, and ONLY performing the E/M service, then he/she would only bill E/M service code without any modifier and the Physician assistant would bill for the procedure code ONLY (without any modifier).

 

If the assistant is having an MD credential, then appropriate modifiers would be 80 (Assistant Surgeon) or/82 (Assistant Surgeon (when qualified resident surgeon not available))

For further reference, kindly find the below link:

 

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/clm104c12.pdf

 

Thank you!

Related Topics