Master multi-provider reporting or risk losing big pay
Published on Wed Oct 21, 2009
Try your hand at deciding between 62, 80, 81 -- or something else. Knowing when to correctly apply modifiers in multiprovider cases is crucial to your bottom line, considering reimbursement ranges from 62 percent of the allowable per surgeon on co-surgery cases to 13 percent for nonsurgeons (such as physician assistants). Last month you brushed up on how to verify each physician's role and treat each surgeon's work as a separate activity when you're coding for multi-provider cases. Now see if your coding lines up with our experts' advice once you consider the nuances between reporting a case as co-surgery, assistant surgery -- or something else. The case: Medical necessity shows that a patient needs both lumbar spinal decompression and fusion, so two surgeons from your group agree to handle the case together. Dr. A performs the decompression; Dr. B (who specializes in fusion procedures) completes the spinal fusion with instrumentation. The [...]
