Wiki Assistant Dr

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hgonzales

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Hi,
We have 2 OB doctors in the same group and who did procedure 58180 (supracervical abd hysterectomy). I billed the 1st doctor 58180 and the 2nd doctor 58180 w/modifier 80 for assistant dr and medicaid denied stating needs attachments which I'm not sure what it meant and when I called they just told me to read the NCCI edits.
Please tell me if only the doctor can get paid and they don't pay for assistant?
If anyone knows situation who deals with this please let me know.

Thank you. :)
Hilda
 
Send the op notes

NOT my area of expertise, but ....

You need to appeal with the operative notes. I'm thinking they just want to see the documentation. CPT 58180 does accept the -80 modifier.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
According to the ACOG coding manual, assistant surgeon should be covered under Medicare/Medicaid. I would do as the other person suggested and appeal with notes.
 
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