tci Outpatient Facility Coding Alert - 2014 Issue 8

Reader Question: Check With Your Payer to Include the Service of Surgical Assistant

Question: The physician does Austin bunionectomy and treats a hallux valgus by surgically treating the MTP joint of the great toe by performing a Chevron osteotomy. He uses a surgical assistant during this procedure. Does the assistant get paid by the insurer? California Subscriber Answer: The first step is to check with your insurers. For instance, if you review the Medicare Physician Fee Schedule, you’ll see that Medicare assigns the “2” indicator to this code in the “ASST SURG” column, which means that “Payment restriction for assistants at surgery does not apply to this procedure...

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