Ob-Gyn Coding Alert

Question: When it comes to assisting (Gyn or C-Section) surgeries — does it matter if the primary physician uses someone in their practice, like a partner, or is it better for them to use someone from the hospital? I’m not sure what prompted this question from some of my providers, but I’m under the impression that the assistant (if it was a partner) didn’t get paid, or paid much, whereas the ones from the hospital are charging crazy amounts and getting paid for those. They would rather use their partners for the assists if it’s going to be worth it for them to help. Hope this makes sense.

Virginia Subscriber

Answer: No one is getting paid crazy amounts for assisting at surgery. The issue is whether an assistant is medically indicated, not who does it so long as that person is an MD (not an RN and of course, the AS (Assistant surgeon) modifier means even less reimbursement for an NP or PA assisting). Some payers might decide that using a partner is trying to game the system, but generally, they look at medical need.