Advanced Search

Orthopedic Coding Alert

Reader Question:

Assistant Surgeon Fees

Published on Wed Dec 26, 2012

Question: When billing for assistant surgeons fees, should I charge full price for the assistant and allow the insurance company to cut the fees, or reduce the fees first?

Delaware Subscriber

Answer: With the amount of reductions already taking place in managed care, practices that discount their fees prior to submitting claims are self-defeating. Always charge the full fee and let the carrier determine the reduction. Charge 100 percent for the assistant surgeon with modifier -80 (assistant surgeon) appended, and let the carrier determine the amount of reduction. Certain carriers may deny the assistant's claim as a duplicate, since both surgeon and assistant are submitting for the same procedure. When this happens, file the surgeons claim first and wait until that is paid to submit the assistant's charge.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Orthopedic Coding Alert

View All