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

Home / Coding Coach / CC-Vascular / 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 or up to four CPT codes.  Follow the prompts and indicate your search is for “payment policy indicators” (see the search choices below, Table 2).  The search will show the codes and several policies, including numbers (see table 3), 0, 1, 2, 9 that indicate the payment status of the code. Table 4, tells you what those codes mean; paid, paid with documentation or not paid.

Table 1

 

Table 2

 

Table 3

Table 4 Policy indicators

Co-Surgeon (62) Assistant Surgeon (80-82)
0 = Co-surgeon not permitted 0 = Paid with documentation
1 = Paid with documentation 1 = Not paid
2 = Paid with two specialties 2 = Paid
9 = Concept does not apply 9 = Concept does not apply

 

*This response is based on the best information available as of 08/24/17.

Newsletter_Signup_CodingCoaches

Sign up for KZAlertsSign up for KZAlerts

Coding Coaches