Wiki How do you determine if an assistant is allowed?

[decoderman1957]

I know CMS has guidelines which state if an assist is allowed, sometimes allowed or not allowed. Is there another source I can use for my physicians who say "This isn't a medicare patient so bill an assistant." 95% of the time the assist is denied and we have to file a pointless appeal.

If you know of a resource other than CMS, please let me know.

I look forward to seeing everyone in Long Beach.

 

[Treetoad]

If you have your RVU file from the Federal Register, you should look at column AA. If you see a number 2 listed in this column, an assistant is allowed.

 

[molivier]

Assist Guidelines

Hello!

Most Insurance companies follow NCCI guidelines on Assists. They also publish the policy. I would call your provider rep if you can't find it on thier webiste.

Hope that helps

Michele

 

[rbeaver]

Good Morning

Just to let you know where I work we use Encoder Pro and it is a wonderful tool for coders. Not only does it list if an assistant can be use with a cpt code, it also gives rules and regulations from medicare and other helpful hints with your coding.