# Resident Surgery



## ancoleman22 (Jan 18, 2018)

Hello All! 

Looking for help clarifying surgical assist involving residents. I'm not 100% comfortable and therefore I keep doubting and confusing myself. 

First off, if a resident is the first assistant, I understand we can not bill for there service but would it be necessary to add a GC modifier to the surgeon's charge?

Second case, multiple residents are assisting the primary surgeon, one resident dictates the actual op note. How would we bill?

Third case, the primary surgeon is assisted by another fellow surgeon with a second assistant of a resident. There is no statement regarding that no adequate resident was available. How would we bill? 

Is the GC only necessary when the resident is actually performing the procedure or is it necessary when they are performing as an assistant as well? 

I keep going back and forth depending on what information I come across. There seems to be so much conflicting information and I am not able to find anything in stone regarding how to bill residents assisting surgeons. 

The GC modifier is a breeze for office visit and hospital visit, it's just the surgical portion that I keep questioning myself! 

Any advice or helpful material would be greatly appreciated! 

Thanks so so so much!


----------



## Patty Basa (Jan 18, 2018)

I add GC modifier to all charges where are resident was involved as you never know if Medicare will be added to the patient account.  For us if the carrier does not accept the GC then it is sent to carrier without the GC, but if GC is required it is on the claim.  

If a resident dictates a physician still needs to review and approve the note and also will need to state he was present for the procedure.

If they don't have a resident statement then I don't bill for an assistant or I will ask the provider if we should be billing for the assistant. 

GC is necessary anytime a resident is involved in the case at all if you are a teaching hospital.  

I have worked in a teaching hospital for the last 20 years.  It's all I know.  

Hope that helps some.


----------



## ancoleman22 (Jan 18, 2018)

LUVCODING said:


> I add GC modifier to all charges where are resident was involved as you never know if Medicare will be added to the patient account.  For us if the carrier does not accept the GC then it is sent to carrier without the GC, but if GC is required it is on the claim.
> 
> If a resident dictates a physician still needs to review and approve the note and also will need to state he was present for the procedure.
> 
> ...



Thank you sooooo much! That's how I was looking at it but then was told differently.


----------



## Patty Basa (Jan 18, 2018)

You are welcome.


----------



## ancoleman22 (Jan 19, 2018)

LUVCODING said:


> You are welcome.



Thank you again! One more question just to be clear. When the resident is the first assistant, is an attestation needed? I have a few where it is just listed with the resident's name as the assistant but nothing else documented on the note?


----------



## Patty Basa (Feb 14, 2018)

I'm so sorry but I missed this.  Yes.  When a assistant is involved where a resident is not available the provider would need to indicate no qualified resident was available to assist.


----------

