Wiki Billing for Surgical Assistant

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lsleaford

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I need help! In the past 9 months, my ob/gyn has employed a private CST whom our office does the billing for. I use modifier AS for her charges. Most insurance carriers won't credential her and tell us to bill under the doctor's name; however, we get frequent denials when we bill under the doctor's name, stating they can't pay him for the surgery and for an assist. My second problem is I have been taught that I can't bill for her services at a teaching hospital where there are residents, unless there are no residents available to assist with the surgery. We don't even attempt to get a resident and my doctor just wants to bill for our CST. I'm not sure if this is ethical. Wouldn't we have to be able to show proof, if asked, that we tried to get a resident to assist? Somebody please help me with this. My doctor is bringing in an outside billing service with no credentials that I don't trust.
 
You are right, most insurances will not credential her and you can not bill her services to CMS at all in any way shape or form.

I have a document saved called the Surgical First Assistant Resource Guide. Try and find that online, it is very informative. I tried to attach it but it is too big. Below is info of the company that put it out there.


Association of Surgical Technologists, Inc.
7108 South Alton Way, Bldg C
Englewood, CO 80112
303-694-9130
303-694-9169
www.ast.org

Good luck,

Laura, CPC, CPMA, CEMC
 
Thank you so much for your reply, Laura. I will definitely print out that resource guide. It always helps to have something in print.
 
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