cmedeiros
New
So here's the scenario, hopefully one of you can help :
Physician A has 4 surgeries scheduled when the night before she injures her wrist and can no longer perform those surgeries. She calls physician B, her colleague who works in the same hospital and specialty to perform those surgeries for her, as the primary surgeon.
However, Physician A performs a small portion of the surgery (CPT code 38792), while Physician B performs the major portions (CPT codes 19303-50 and 38525-50).
Would it be appropriate to bill for the services indicating Physician A as the assistant and append modifier 80 to CPT 38792? According to Medicare guidelines, in a teaching hospital (which my hospital is considered) an assistant surgeon is only appropriate when there is no qualifiying resident available to perform the surgery. I don't know that this was the case in this scenario.
http://www.ngsmedicare.com/content.aspx?CatID=2&DOCID=2183
Also, if I were to bill Physician A as having performed 38792 with modifier 80, would I do the same for Physician B since she is the primary surgeon in this case?
How do I bill for these services?
Please help!!
Physician A has 4 surgeries scheduled when the night before she injures her wrist and can no longer perform those surgeries. She calls physician B, her colleague who works in the same hospital and specialty to perform those surgeries for her, as the primary surgeon.
However, Physician A performs a small portion of the surgery (CPT code 38792), while Physician B performs the major portions (CPT codes 19303-50 and 38525-50).
Would it be appropriate to bill for the services indicating Physician A as the assistant and append modifier 80 to CPT 38792? According to Medicare guidelines, in a teaching hospital (which my hospital is considered) an assistant surgeon is only appropriate when there is no qualifiying resident available to perform the surgery. I don't know that this was the case in this scenario.
http://www.ngsmedicare.com/content.aspx?CatID=2&DOCID=2183
Also, if I were to bill Physician A as having performed 38792 with modifier 80, would I do the same for Physician B since she is the primary surgeon in this case?
How do I bill for these services?
Please help!!