Mfink
New
I am new to coding and still learning lots. I work for an ENT practice and wanted to know if you can bill 42335 and 42660 with modifier 80 to show assistant surgeon?
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Wiki 42335 and 42660
- Thread starter Mfink
- Start date
You can look on the Medicare physician fee schedule to determine whether an assistant surgeon can be billed for any CPT.
CPT 42335 and CPT 42660 both have Assistant Surgeon indicators of 1. This means that there is a statutory payment restriction and assistant surgeons may not be paid.
CMS Physician Fee Schedule Lookup Tool: https://www.cms.gov/medicare/physician-fee-schedule/search
The meanings of the indicators on the fee schedule are:
0 = Payment restriction for assistants at surgery applies to this procedure unless supporting documentation is submitted to establish medical necessity.
1 = Statutory payment restriction for assistants at surgery applies to this procedure. Assistants at surgery may not be paid.
2 = Payment restriction for assistants at surgery don’t apply to this procedure. Assistants at surgery may be paid.
9 = Concept doesn’t apply.
Mfink
New
Thank you. This information was very helpful.