alisac
Guest
There seems to be a bit of confusion when it comes to the required documentation that needs to be in the body of an primary surgeons operative note when using a non-physician practitioner assistant at surgery(modifier "AS"). In researching CMS guidelines and Medicare Physician Fee Schedule for NPP it clearly defines when it is necessary to document in body of the op note the medically necessity of an assistant at surgery to be present in the case.
Payment indicators are issued by MPFS in regards to NPP assist at surgery.
Payment Indicators are as follows:
2 - Medicare will pay for an assistant-at-surgery for that particular code, additional documentation is not required as the CPT has already been deemed medically necessary.
0 - Medicare MIGHT pay for assist-at-surgery, additional documentation IS required to substantiate medical necessity.
1 - An assistant-at-surgery will NOT be paid.
9 - Assistant-at-surgery concept in surgery does not apply, another words no reason for an assist, don't even bill for it with any modifier.
Educate your surgical coders to review the payment indicators for your most frequently used CPT codes to make sure you are accurately coding for assist-at-surgery and you are not making extra work for your surgeon when doing their dictation/documentation. When payment indicator 2 is attached to your CPT code there is NO formal requirement to have supporting language in the op note, and it is not mandated by CMS(Medicare/Medicaid) or commercial payers.
AlisaC
Payment indicators are issued by MPFS in regards to NPP assist at surgery.
Payment Indicators are as follows:
2 - Medicare will pay for an assistant-at-surgery for that particular code, additional documentation is not required as the CPT has already been deemed medically necessary.
0 - Medicare MIGHT pay for assist-at-surgery, additional documentation IS required to substantiate medical necessity.
1 - An assistant-at-surgery will NOT be paid.
9 - Assistant-at-surgery concept in surgery does not apply, another words no reason for an assist, don't even bill for it with any modifier.
Educate your surgical coders to review the payment indicators for your most frequently used CPT codes to make sure you are accurately coding for assist-at-surgery and you are not making extra work for your surgeon when doing their dictation/documentation. When payment indicator 2 is attached to your CPT code there is NO formal requirement to have supporting language in the op note, and it is not mandated by CMS(Medicare/Medicaid) or commercial payers.
AlisaC