Wiki CABG Assist

[cargo]

Can I bill 2 different surgical assists – the PA did the vein harvesting, then the surgeon had trouble and called another surgeon in to assist with the bypasses. Can I assign the 33508/80 to the PA, and the CABG codes to the 2nd surgeon?? (Medicare)


Thanks in advance,
C. Wright, CPC

 

[mallikarjun.bandela]

Modifier 80 cannot be appended to PA. second surgeon who is assisting the primary surgeon shoud be reported with Assistant surgeon modifier for CABG procedure.

 

[Cyndi113]

Actually, Cargo, check with your carrier. If your PA is contracted as a surgical assist then yes you can bill.

 

[cyndiann]

Actually, if you bill for your PA, you would bill the 35308 with no modifier, because he/she is primary for that procedure only. In that case, you would not bill the 35308 for the surgeon at all.

 

[slc112071]

You have to watch the 33508. It cannot be the only code billed if that is all that the PA did due to it being an add on code.

 

[emoates]

I had trouble billing the 33508 code for my PA with Medicare. Medicare kept telling me I was unbundling so our billing process was changed so that the 33508 is billed under the surgeon even though our PA performs the vein harvest.

 

[igarza]

Assistant surgeons (MD) 80 or 82 modifer and AS modifier for PA or NP....Most group policies do allow for two surgical assistants. I do know that Medicare does allow for two surgical assistants for certain procedures.

 

[banjo]

Is there any way to distinguish between the first PA assist and the 2nd PA assist?

 

[kreuschle]

NPP Assistant Surgeon

What about reimbursement from commercial plans for a nurse practitioner assistant surgeon (modifier AS)? Does anyone expect to be paid by them? We have several who I am told 'do not accept' nurse practitioners, but this seems ridiculous.