Neurosurgery Coding Alert

PAs are licensed healthcare professionals who may, under a physician's supervision, practice medicine in any setting, including a physician office, clinic or hospital.

Scope-of-practice laws vary from state to state, but in most cases PAs can, for instance, take a patient's history, perform a physical exam, order and interpret tests, provide patient follow-up (including hospital rounds) and assist during surgery.
 
A PA bills for his services using a dedicated personal identification number (PIN). Generally, PA's receive reimbursement equal to 85 percent of the rate paid to a physician in the same circumstances.

For instance, if the insurer pays a physician first surgical assistant 16 percent of the primary surgeon's fee of $1,000, or $160, a PA serving as first assistant for the same surgery would receive $136 ($160 x 0.85).

Don't confuse PA services with "incident-to": Services provided by a PA billing under his own PIN are distinct from services provided incident-to a physician. You should report incident-to services under the physician's PIN. Payers reimburse incident-to services at 100 percent of the usual rate.