Billing Medicare for Assistant at Surgery

An Assistant at Surgery is a provider who actively assists the physician in charge of a case in performing a surgical procedure. A physician, nurse practitioner, physician assistant, or clinical nurse specialist who is authorized to provide such services under state law can serve as a surgery. Medicare considers advanced registered nurse practitioners (ARNP), physician […]


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Basics of Co-Surgeon Billing Guidelines

Under some circumstances, the individual skills of two or more surgeons are required to perform surgery on the same patient during the same operative session. This may be required because of the complex nature of the procedure(s) and/or the patient’s condition. In these cases, the additional physicians are not acting as assistants at the surgery. […]


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How Does Modifier 62 Affect Reimbursement?

Modifier 62 will be added to claims for procedures designated as “co-surgeon allowed” when a claim for the same procedure code with it has been previously submitted and processed for a different provider. Claims for more than one surgeon should have each surgeon’s provider identification number. The following Situations are Considered Co-Surgery: Two surgeons of […]


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Adult Elective Surgery and Procedures Recommendations during COVID-19

To aggressively address COVID-19, CMS recognizes that the conservation of critical resources such as ventilators and Personal Protective Equipment (PPE) is essential, as well as limiting exposure of patients and staff to the SARS-CoV-2 virus. The following recommendations are guidance to limit non-essential adult elective surgery and medical and surgical procedures, including all dental procedures. […]


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How to code correctly for laceration repairs?

Answering a few questions will help you code correctly for laceration repairs (such as staples, sutures, or similar closure materials): Was the repair limited to the epidermis, dermis, and subcutaneous tissue, or did you need to probe more deeply? Use simple repair codes for superficial wounds (epidermis and dermis) that need only a single-layer closure. […]


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Using Correct Combinations – Modifier 24 and 25

One of the most frequent errors can result from the submission of invalid modifier combinations. In addition to the accurate coding of treatment, medical claims must be billed in combination with codes for additional services performed in the office, the corresponding modifiers, if necessary, and ICD-10 or diagnosis codes. The most commonly used wrong modifier […]


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Key Points for Assistant-at-Surgery Billing

Assistant surgeon billing can seem overwhelming, so it’s crucial to take it one step at a time. But there are several key points to remember that will make it much easier to understand. Assistant at Surgery: An assistant at surgery is a physician or non-physician practitioner who actively assists the surgeon and goes beyond providing […]


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Here’s Why Medicare Isn’t Paying You?

There are two main categories of services which a physician may not be paid by Medicare: Services not deemed medically reasonable and necessary Non-covered services In some instances, Medicare rules allow a physician to bill the patient for services in these categories. Understanding these rules and how to use them in your practice increases the […]


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