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for procedure "44140" with modifier 82

Kinyi Posted Mon 16th of January, 2012 21:09:16 PM

Can the assistant surgeon bill the same amount billed by the principal surgeon?

SuperCoder Answered Thu 16th of February, 2012 10:43:31 AM

Yes, assistant surgeon should bill the same procedure billed by principal surgeon, but the services are customarily reimbursed at 16 percent of the fee schedule amount of the surgical procedure, and are subject to multiple surgery pricing rules. The allowed amount for assistant-at-surgery services performed by a nurse practitioner, physician assistant or clinical nurse specialist is the lesser of 80 percent of the actual charge, or 85 percent of the 16 percent allowed based on the physician fee schedule.
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Reimbursement of assistant-at-surgery services for a physician billing
For example 33300--Physician fee amount ($2513)--Assistant at reduction (16%)=$2513*16%=$402.08(final allowance)
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Reimbursement of assistant-at-surgery services for nurse practitioner (NP), physician assistant (PA), or clinical nurse specialist (CNS)
For example same CPT 33300--Physician fee amount ($2513)--Assistant at reduction (16%)=$2513*16%=$402.08, non-physician reduction (85%) of Asst. reduction =$402.08*85%=$341.70 (final allowance for non-physician reduction)
Hope this helps.

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