Wiki 29881 asst surgeon (as modifier)

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NANETTEMART

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Can anyone help me understand why Medicare does not reimburse for the 29881-AS? I have searched high and low for an answer and all I keep getting is that they just don't pay for it. Does anyone know why its allowed per CCI and AMA and not medicare?
 
Check for Medicare's bundled procedures list that came out 2 years ago that stated the procedures that they would no longer cover, I could have sworn I saw arthoscopy of the knee as one of the procedures they were no longer paying for. Medicare decided back in 2009 that they were not going to pay for surgeons to look around (oscopy) just for the surgery only. If you can't find the list let me know and I will try to find it for you.
 
NANETTEMART said:
Can anyone help me understand why Medicare does not reimburse for the 29881-AS? I have searched high and low for an answer and all I keep getting is that they just don't pay for it. Does anyone know why its allowed per CCI and AMA and not medicare?
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I'm sure they're denying based on medical necessity. What is the need for an Assistant Surgeon/PA for a menisectomy. It's a rather simple procedure that 1 Doc can handle alone. If I was an Insurance co I wouldn't pay either..
 
Thank you for your response. It would be greatly appreciated if you can guide me to where that information is located.
 
the CMS website has the information and also a list of all procedures they no longer cover for assists. - look under Part B fee schedule calculator. I had the same problem and had to do a lot of searching and found non-payable codes for Medicare 2011. hope this helps!:)
 
NANETTEMART said:
Yankee: Thank you for your honest answer but I need facts to provide to our Docs.
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don't have an official document for that. I would explain it to your doc as if he were being asked to pay out of his pocket for this procedure. He might agree with my thoughts. I sometimes try to put myself in the "other shoes" to get an idea as to what they're thinking & why. But you have every right to appeal as 29881 is Assistant eligible. I just think you're going to spend a lot of time and resources and get nowhere for only a possible hundred dollars or so more..if that. Goiod luck!
 
schotty63 said:
the CMS website has the information and also a list of all procedures they no longer cover for assists. - look under Part B fee schedule calculator. I had the same problem and had to do a lot of searching and found non-payable codes for Medicare 2011. hope this helps!:)
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do you have the link?
 
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