Wiki Assistant Surgeon Question

[cdenglish]

Can anyone tell me if an assistant surgeon (modifier 80) will be paid for an implantable penile prosthesis (CPT 54400, 54401 or 54405)? I am researching this for a client and thought I would start here.

 

[jettagirlfl]

54405 accepts it

 

[susanp]

I believe that Medicare allows payment for an assistant surgeon for 54405. Codes 54000 and 54004 do not allow payment for an assistant surgeon.

If this is not a Medicare patient, then the third party payer for the patient would need to be contacted to see what their guidelines are for paying assistants at surgery.

 

[annakilker]

implantable penile prosthesis

Medicare allows coverage for eligible claims. Some commercial carriers have excluded coverage for this procedure (check benefits for sure).