# Billing NP as surgical assistant



## PamBorden (Feb 13, 2009)

We have recently acquired a NP to assist our Ortho Dr. in surgery. He states her name as assistant on the op note heading. Does he also have to mention her name in the body of the report? Is it enough to have her name listed under his on the op report?


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## FTessaBartels (Feb 13, 2009)

*Body of report*

He should also indicate what the nature of her assistance was in the body of the report. 

If he is in a teaching hospital, he must also indicate that there is no qualified resident available and therefore the NP assisted.  

If the NP is performing procedures on her own, she should be dictating her own notes and those should be billed under her name/NPI. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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## PamBorden (Feb 13, 2009)

*NP as surg assist*

So he is supposed to dictate, "NP Jane Doe held retractors . . "? Is that what is required? Thanks for your quick answer, Tessa.


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## RebeccaWoodward* (Feb 13, 2009)

Our carriers are not too fond of simply stating the name of the assistant.  With recommendation, my surgeons now give a brief description of the role of the assistant. Example...

Dr. Doe dictates that Jane Smith, PA,  remained active in the case assisting with instrumentation and documents the medical necessity of having an assistant for the remainder of the case.


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## mbort (Feb 16, 2009)

my docs have a standard template for most of their cases.  It states:

Assistant:  John Doe, PA-C.  This operation could not have been safely performed (without compromising the technical results or length of the procedure) without the assitance of a skilled surgical assistant.  A surgical assistant was medically necessary for positioning, retraction and instrumentation throughout this surgical encounter.

Sometimes it works...sometimes it doesnt 

Mary,CPC,COSC


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## PamBorden (Feb 17, 2009)

Thank you Mary and Rebecca. I had a talk with my surgeon today who stated- "No one else does this. . . . ". I'm going to have an uphill battle here.


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## mbort (Feb 18, 2009)

PamBorden said:


> Thank you Mary and Rebecca. I had a talk with my surgeon today who stated- "No one else does this. . . . ". I'm going to have an uphill battle here.



yw, 
I'll bet if he checked around with other surgeons, one of two things would be discovered.  1) those "No one's" are not getting paid for the services or having a much harder time and having to appeal with letters of medical necessity" B) he would find that they really are doing it, he just doesnt know it.

grrrrr docs...some of them are missing the "common sense" part of their education!  If they would just do what we tell them it would make our lives so much easier


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