Assistant Surgeon

Having issues getting some assistant surgeon bills paid. According to my coding book some codes are payable only with documentation. I send in documentation noted in the operative report and get letters back saying it is not payable.
Having trouble with knee scopes in particular. They will say 29881 is not reimburseable when billed with 29879.

I use a AS modifier and 59 modifiers when it is the secondary procedure code.

Any help would be greatly appreciated.

Katie

re: Assistant Surgeon

Hello Katie:

It appears you are billing this service accurately. I would venture to say your problem is likely documentation. I researched AAOS and found a article that you may find helpful here is a quote from it "If the CPT® code has a “0” status indicator, the operative note will need to clearly state why the assistant was required and the extent of the work performed by the assistant to support payment. The primary surgeon is responsible for including this enhanced documentation in the operative note. Without such information, billing personnel will find appeal efforts difficult." You may read the article in its entirety at http://www.aaos.org/news/bulletin/jun07/managing5.asp. Reviewing your documementation and sharing the AAOS article with your docs may be helpful. Each month I browse the AAOS Now articles and forward relative articles to my group doing so has been very helpul as AAOS is a resource they both acknowledge and respect. I also have a work aid I give to my doc if you need it give me your email and I will send it as well. Best wishes!