Month: August 2017

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Assistant Surgeon Payments

August 24, 2017 Question: We are seeing payers ask for payment back when we use Modifier 80 for assistant surgeon. Is there a reason why they would take the payment back? Answer: We are seeing many payers including Medicare and Medicaid ask for payment recovery when the documentation does not explain what role the assistant...

Billing for Pre-Op H&P Visit
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Billing for Pre-Op H&P Visit

August 24, 2017 Question: Hospitals require that we do an H&P within 30 days of taking a patient to the OR. If this visit is more than 48 hours prior to surgery, is that a billable visit? Answer: No, the H&P in this case is not a billable visit.  This question comes up often and...

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How do I know if co surgeon will be paid? What about assistant surgeon?

August 24, 2017 Question: How do I find out if an assistant surgeon or co-surgeon is paid on certain procedures that I perform? Answer: This information is published by Medicare on the Medicare website. https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PFSlookup/index.html You can also google “Physician Fee Schedule Look up” to access the site. Once there, you can enter a single...

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Navigation x 2?

August 24, 2017 Question: I’ve got an upcoming case where I’m removing two different brain tumors and I’ll be using neuronavigation (+61781). Since I have to make 2 plans, register the coordinates twice, and plan 2 separate trajectories, can I report +61781 twice (+61781, +61781-59 or +61781 x 2 units)? Answer: No. The CPT Assistant,...

Global Period for Surgery. Is it billable?
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Global Period for Surgery. Is it billable?

August 24, 2017 Question: A Medicare patient of mine presented to the Emergency Room with an infection at the surgical incision site from a surgery that I did 4 weeks ago. The surgery has a 90 day global. I was on vacation so my covering physician saw the patient and admitted her. The procedure has...

Scribe Question
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Scribe Question

In my office, we use a PA as a scribe for new patient office visits for our doctors. We have an electronic medical record and the scribe signs in under her own name when she begins notating for the doctor. What is the correct way to notate in the medical record that the PA is only acting as a scribe and not performing the service personally?

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