What is the reimbursement for an assistant surgeon using modifier 80? Is the payment different for the primary and the assistant?
Month: August 2016
Patient comes in for what they are calling scar revision and the note states that “standing cutaneous excess of the left abdominal scar” was sharply excised. We are billing with a diagnosis of hypertrophic scar (L91.0) and CPT codes of 11406 (excision of benign lesion) and 12034 (intermediate repair) for the procedure. On speaking with a co-worker regarding the note, since I’m new to plastics surgery, we are wondering if we should bill 15830 with 52 modifier because it appears to me that the excess skin is being removed. What do you think?
What reimbursement should we expect when using the global period modifiers 58, 79 and 78?
What is the reimbursement for co-surgery? Is it different for the primary and co-surgeon?
I was called into the OR by a urologist who was doing a nephrectomy for a malignancy. He noted a lesion on the spleen I was called in to remove the spleen. Is this co-surgery or assistant surgery?
I did an anterior and posterior spine procedure on the same day. I used local bone graft (20936) and morselized allograft (20930) on the anterior and posterior procedures. Should I bill 20930, 20930-59, 20936, 20936-59 or 20930 x 2 units with 20936 x 2 units?
Do I have to sign each of my NP’s notes that are reported incident to?
We have a billing company for which we bill for many different specialties. We have an orthopedic spine doctor who insists we bill the cage code 22851 for each inter-space. However, the CPT book lists as cage(s) therefore our thinking is that no matter how many are placed this code is only allowed one time per surgery. His note states “C3-C4, C4-C5, C5-C6 anterior cervical interbody fusion using PEEK titanium interbody spacers.”
I heard you say at a course (you were great, by the way. I learned a lot from you!) that we should wait for a pathology report before billing for excision of skin lesions. Please explain why. This may be why I’m not getting paid.
What is the reimbursement for co-surgery using modifier 62? Is it different for the primary and co-surgeon?