Forum - Questions & Answers

Jul 3rd, 2014 - swalker216

Assistant surgeon

I need another opinion please

On the MPFS schedule for assistant surgeons, the codes describing whether they can get paid or not. I am getting different interpretations for the descrip.

0-Payment restriction for assistants at surg applies to the procedure unless supporting documentation is submitted to establish medical necessity.

1-Statutory payment resstriction for assistant surgeons applies to this procedure.
Assistant at surgery may not be paid.

2-Payment Restrication for assistants does not apply to this procedure. Assistant
surgeons may be paid.

I am having trouble with "1"- The PA insists that this will be paid if we send notes.
I am saying it won't be paid.

Anyone else have any ideas?


Jul 9th, 2014 - Codapedia Editor 1,399 

re: Assistant surgeon

I agree with you.

0: may or may not be paid, need to show medical necessity.

1: no payment

2: payment without notes--assumed to be medically necessary.

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