Explore reports on this topic from the Council on Medical Education presented during the AMA Interim and Annual Meetings. Chicago, IL 60611. Policy. Each surgeon will be reimbursed 62.5% of the allowed amount. Reimbursement is not allowed for more than one assistant surgeon. CPT code 37217 (transcatheter placement of intravascular stent[s], intrathoracic common (Examples: Obstetrical Billing & Multiple Birth Guidelines Quick Reference Guide . The AMA does not directly or indirectly practice medicine or dispense medical services. % This page outlines the basis for reimbursement if the service is covered by an Anthem member's benefit plan. Access reports from the Council on Medical Education presented during the AMA Annual and Interim Meetings. 21085 $393.00 Assistant surgery modifiers 80, 81, 82, AS, SA 21034 $1,048.00 Minimal surgical assistance may be identified by adding the modifier 81 to the usual procedure code, and describes an assistant surgeon providing minimal assistance to the primary surgeon. 20205 $238.00 Modifier 90; Reference (Outside) Laboratory . Find information about the summary of panel actions, a document prepared after each meeting of the CPT editorial panel. 0000070634 00000 n CMS Internet Only Manual (IOM) Reason & Remark Codes ; Acronyms and Glossary ; Calculators/Tools : External Resources; www.CMS.gov ; Assistant Surgeon Policy Oxford Health PlansAssistant Surgeon Policy: Reimbursement Policy (Effective 01/11/2016) CPT/HCPCS codes allowed for assistant surgeon reimbursement) to reflect annual code edits: o Added 54437 and 54438 o Removed 21810, 33332, 33472, 33960, 42508, 43350, MODIFIERS Professional Claims BCBSTXMODIFIERS Professional Claims Effective 8/27/07 Blue Cross and Blue Shield of Texas/HMO Blue Texas accept all valid CPT and HCPCS Assistant Surgeon Modifiers Modifier 80, 81, 82: Denote assistant surgeons. Gastric Bypass for Morbid Obesity. The revenue codes and UB-04 codes are the IP of the American Hospital Association. 21338 $483.00 Confidential 21209 $571.00 Assistant Surgeon and Cesarean Sections Only a non-global cesarean section delivery code (CPT codes 59514 or 59620) is a reimbursable service when submitted with an appropriate assistant surgeon modifier. You acknowledge that the AMA holds all copyright, trademark, and other rights in CPT. 20663 $404.00 20922 $504.00 21244 $959.84 Several general guidelines are repeated in this Chapter. All Rights Reserved to AMA. 0000004776 00000 n Before you can enter the Noridian Medicare site, please read and accept an agreement to abide by the copyright rules regarding the information you find within this site. LICENSE FOR NATIONAL UNIFORM BILLING COMMITTEE ("NUBC"), Point and Click American Hospital Association Copyright Notice, Copyright 2021, the American Hospital Association, Chicago, Illinois. 21199 $950.84 0000061060 00000 n While reimbursement is considered, payment determination is subject to, but not limited to: In instances where the provider is participating, based on member benefits, co-payment, coinsurance, and/or deductible shall apply. Learn about the latest changes for CPT Category III Codes for emerging technologies, services and procedures. Fargo, N.D., 58121. References Assistant at surgery modifiers Not every residency match is made to last, as more than 1,000 residents transfer programs each year. 20938 $182.41 College of Surgeons as its primary source for determining if an assistant surgeon is clinically valid for a, CMS Manual System . College of Surgeons as its primary source for determining if an assistant surgeon is clinically valid for a, CMS Manual SystemCMS Manual System . Reimbursement by Procedure Codes 20000 29999 Effective Jan. 1, 2015, These rates are provided for informational purposes only and are not to be considered a guarantee of payment. Any questions pertaining to the license or use of the CDT should be addressed to the ADA. 0000005853 00000 n Medical CPT codes are critical to streamlining reporting and increasing accuracy and efficiency, as well as for administrative purposes such as claims processing and developing guidelines for medical care review. subject to the assistant-at-surgery policy. Telehealth provides a way for physicians to provide care while keeping patients safe in their homes. The American College of Surgeons (ACS), in collaboration with 15 other national specialty surgical organizations, has recently published the eighth edition of thePhysicians as Assistants at Surgeryreport, a study first undertaken in 1994. State Exceptions Colorado Colorado is exempt from this policy. The CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. Benefits will be derived based on CMS designation for Assistant Surgeon. 60000 62281 64479 64744 65775 66982 67800 68340 69450 60100 62282 64480 64774 65778 66983 67801 68360 69501 60300 62284 64483 64776 65779 20600 $48.20 Benefit Restrictions . endstream endobj 20101 $238.00 Those where the assistant surgeon concept does not apply (Indicator 9). 17% of the fee schedule (Fee Schedule Amount x 85%) x 20%. The sole responsibility for the software, including any CDT and other content contained therein, is with (insert name of applicable entity) or the CMS; and no endorsement by the ADA is intended or implied. Updated cross references and policy format. These materials contain Current Dental Terminology, (CDT), copyright 2020 American Dental Association (ADA). 0000004872 00000 n Medicare reimburses services rendered for assistant at surgery by a physician performing as a surgical assistant at 16 percent of the MPFS amount. Specific issues unique to this section of CPT are clarified in this Chapter. You may also contact AHA at ub04@healthforum.com. 21320 $222.72 LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT"). If you choose not to accept the agreement, you will return to the Noridian Medicare home page. Assistant surgeons submit procedure code (s), with the appropriate modifier appended (80, 81, 82, or AS) to represent their service (s). Assistant Surgeon Payable on Particular CPTs? - AAPC 20926 $361.00 Should be submitted on those surgical, Procedure 1206- Assistant Surgeon Purpose: ProcedureProcedure 1206- Assistant Surgeon Lines of Business: All Purpose: This Network Health guideline describes services provided by assistant surgeons that Global cesarean section CPT codes submitted by an assistant surgeon will be reimbursed using the. CPT has responded by adding six new codes to report online digital evaluation services, or e-visits. 21142 $1,243.31 CPT Level I codes & modifiers HCPCS Level II codes & modifiers CDT CPT Assistant +Archives AHA Coding , CPT Codes And Fees: 2015 CPT Codes North Carolina, CPT Codes and Fees: 2015 CPT Codes. BY CLICKING ABOVE ON THE LINK LABELED "I Accept", YOU HEREBY ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTOOD AND AGREED TO ALL TERMS AND CONDITIONS SET FORTH IN THESE AGREEMENTS. 109. 20802 $2,362.52 Applications are available at the AMA Web site, https://www.ama-assn.org. 21079 $1,632.40 <> 21206 $1,019.00 Treatment Description. The Allowable . CPT Code Reimbursement ADA DISCLAIMER OF WARRANTIES AND LIABILITIES. Organizations that collaborated with the ACS to conduct the study include the American Academy of Ophthalmology, the American Academy of Orthopaedic Surgeons, the American Academy of OtolaryngologyHead and Neck Surgery, the American Association of Neurological Surgeons, the American Pediatric Surgical Association, the American Society of Colon and Rectal Surgeons, the American Society of Plastic Surgeons, the American Society of Transplant Surgeons, the American Urological Association, the Congress of Neurological Surgeons, the Society for Surgical Oncology, the Society for Vascular Surgery, the Society of American Gastrointestinal Endoscopic Surgeons, the American College of Obstetricians and Gynecologists, and the Society of Thoracic Surgeons. Surgery: Cardiovascular System 1. a. The American Medical Association (AMA) has several resources to help accurately bill procedures and services with the Current Procedural Terminology (CPT) code set and Healthcare Common Procedure Coding System (HCPCS) codes. Assistant at surgery may be paid. 20936 $204.00 Procedures billed with the assistant-at-surgery physician modifiers -80, -81, -82, or the AS modifier for physician assistants, nurse practitioners and clinical nurse specialists, are. trailer Procedures with a global period of MMM are maternity procedures. A physician should not report multiple HCPCS/CPT codes if a single HCPCS/CPT code exists that describes the services. Current Procedural Terminology (CPT) codes provide a uniform nomenclature for coding medical procedures and services. Confidential 21315 $181.00 2. A HCPCS/CPT code should be reported only if all services described by the code are performed. HCPCS/CPT codes include all services usually performed as part of the procedure as a standard of medical/surgical practice. 21045 $1,132.57 *This list may not contain all Assistant Surgeon codes. Assistant Surgeon The procedures codes listed on the Fee Schedule are the only Coverage services reimbursable to an . Modifier 62 - two surgeons or cosurgeons - Regence Assistant surgeons should bill the same CPT surgical procedure codes as the primary surgeon with either modifier "80" or "82." Assistant surgeons are reimbursed at a percentage of the allowed amount for primary surgeons. THE LICENSES GRANTED HEREIN ARE EXPRESSLY CONDITIONED UPON YOUR ACCEPTANCE OF ALL TERMS AND CONDITIONS CONTAINED IN THESE AGREEMENTS. Example 2: Right cataract extraction (CPT code 66984) was performed on May 1, 2009. For U.S. Government and other information systems, information accessed through the computer system is confidential and for authorized users only. 0000008064 00000 n Assistant Surgeon/Assistant At Surgery Covered ProceduresAssistant Surgeon/Assistant at Surgery Covered Procedures system related to procedure codes allowed to be billed with either the 80 or AS modifier. All our content are education purpose only. PDF Assistant-at-Surgery Services Policy, Professional - UHCprovider.com 21088 $474.74 A HCPCS/CPT code should be reported only if all services described by the code are performed. Ambulatory Surgical Center (ASC). Medicares policies on billing patients in excess of the Medicare allowed amount apply to assistant-at-surgery services. All rights reserved. This Agreement will terminate upon notice to you if you violate the terms of this Agreement. 21012 $329.50 0000001846 00000 n Reimbursement for a second assistant surgeon is allowed. No fee schedules, basic unit, relative values or related listings are included in CPT. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. 0000001740 00000 n U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements. CPT code 20000 - 29902 - Not reimbursed for assistant surgeon by Lori | Oct 10, 2011 | CPT modifiers CPT Codes 20000 - 29999 The principles of correct coding discussed in Chapter I apply to the CPT codes in the range 20000-29999. the assistant surgeon indicator in the Professional Services Fee Schedule to determine if assistant surgeon fees are payable. endobj In addition, the 2018 report updates 384 revised codes and deletes 48 codes that are no longer in CPT. CPT Codes and Fees, Effective January 1, 2014. 20950 $131.00 When reporting services provided by non-physician practitioners acting as assistants at surgery, append modifier AS to the procedure code used to report the surgeons service. 21256 $1,089.96 21282 $322.17 %PDF-1.4 % Reimbursement by Procedure Codes 20000 29999 Effective Jan. 1, 2015 Contractors may not pay assistants-at-surgery for surgical procedures in which a physician is used as an assistant-at-surgery in fewer than five percent of the cases for that procedure nationally. To report services of an assistant surgeon, the following surgical modifiers should be appended: 80 Assistant Surgeon: This modifier pertains to physicians services only. Discover CPTs role in promoting optimal health for all. 21154 $2,034.89 3 surg cardio. The deadline to claim CME credit for the March issue is May 31, 2022. Pathology and Laboratory. 20150 $850.85 All Rights Reserved to AMA. Assistant surgeon CPT codes Medical Billing CPT ModifiersAssistant surgeon CPT codes not covered list 3000 39400 30000 procedure codes that are "Nevers" for assistant surgeon. Surgeon who performed surgery (s) with two or more other surgeons; all surgeons must add CPT Modifier 66 to the surgical procedure Procedure codes that have a TEAM 1 or 2 indicator on the MPFSDB must be submitted with supporting documentation CPT Modifier 80 Assistant Surgeon (Physician). Visit the AMA Store for coding resources from the authoritative source on the CPT code set. Assistant at Surgery - Group and Individual. Added a note that codes are updated quarterly. 21340 $742.14 hb```^V @16, ' 00oX>lbR{X`GX&~"IuEMe>grv%*:;kl`6 HxkVb5?}&H>d8`pC5BQ@Ko7sRw> , Stay informed with the latest updates from the AMA. 21208 $884.00 43846 80 . 0000018245 00000 n 0000013889 00000 n 0000067999 00000 n <>/Rotate 0/Type/Page>> %%EOF Evaluation and Management (E&M) Services Medicare Global Surgery Rules define the rules for reporting evaluation and management (E&M) services with procedures covered by these rules. NOTE: Physicians acting as assistants cannot bill as co-surgeons. As for S2068, many payors who recognize this code generally do not recognize payment for an assistant or co-surgeon on the same code. maternity "Delivery only" codes may be eligible for assistant modifiers. First Assistant Not Payable Under Medicare for 2017 Page 1 - AAPA 0000034523 00000 n 21137 $679.31 You should report inpatient consultation services using an Initial Hospital Care code (99221-99223) for the initial evaluation, and a Subsequent Hospital Care code (99231-99233) for subsequent visits. The ADA expressly disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. 20553 $29.00 If you find anything not as per policy. The global concept does not apply to XXX procedures. 0000011635 00000 n All procedures on the Medicare Physician Fee Schedule are assigned a global period of 000, 010, 090, XXX, YYY, ZZZ, or MMM. iPhone or Modifiers - JE Part B - Noridian Mandated or legislative required criteria will always supersede. 20827 $1,844.00 This warning banner provides privacy and security notices consistent with applicable federal laws, directives, and other federal guidance for accessing this Government system, which includes all devices/storage media attached to this system. stream 0000020513 00000 n Council on Long Range Planning & Development. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Need coding resources? | American Medical Association Officials and members gather to elect officers and address policy at the 2023 AMA Annual Meeting being held in Chicago, June 9-14, 2023. 4/2022. var url = document.URL; 4 0 obj 20680 $389.00 p20@ !| :F8 80 NoridianAssistant surgeon may be paid. This type of unbundling is incorrect coding. 21029 $659.00 A physician should not separately report these services simply because HCPCS/CPT codes exist for them. Reimbursement by Procedure Codes 20000 29999 Effective Jan. 1, 2015 x=k]o'my8]*Ud7v8ko]6Zo~%n4~~kV m[-ef/SufspbZ?1xn_8 DE 0vW]y#?=p?: 0"W2/"(2[ida_(?.(W?/y{@0J:e^r"l0f*u7sysd|76s!8>(K,2CD? Ua:Te'vIBcjxD?8hX`h:P0B#::\F!%4 ?cX4bk* ?21j3$ y]~3htrrppC oa\;33. CPT/Modifier. Get timely provider information including policy, benefits, coding or billing updates, education, and moredelivered directly to your email. Correct Use Physician: Assist-at-surgery allowed with appended modifiers 80, 81, or 82 Allowed = 16% of surgery fee schedule allowable Note: Non Physician Practitioner (NPP) or mid-level practitioner (PA, NP, CNS): Append AS modifier only Allowed equals 85% of surgical assist or 16% allowable Incorrect Use 81 Assistant Surgeon: This modifier pertains to physicians services only. Keep in mind that determination of coverage under a member's plan does not necessarily ensure reimbursement . 20501 $23.44 25 37 21267 $1,489.00 Note: Non Physician Practitioner (NPP) or mid-level practitioner (PA, NP, CNS): Allowed equals 85% of surgical assist or 16% allowable, Inappropriate to bill AS modifier for physician surgical services, Inappropriate to append modifier 58 (staging) with assistant surgery. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT. 21073 $305.61 AMA Press. Coding for Evaluation and Management Services | AAFP Please reach out and we would do the investigation and remove the article. <<4920F65ACFB5B2110A0060FF8C42FF7F>]/Prev 129922>> CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. A licensed physician assistant 3. 0000002288 00000 n CPT Code Reimbursement All codes in the NPFS with the status code indicator "1" for "Assistant Surgeons" are considered by UnitedHealthcare Medicare Advantage to not be reimbursable for Assistant Surgeon services, as indicated by an Assistant Surgeon or surgical assistant modifier (80, 81, 82, or AS), and will not be allowed for payment. Obstetrical Billing & Multiple Birth Guidelines Quick Surgical Complications These services should be coded separately using CPT codes from the Surgery section of the CPT manual. Current Procedural Terminology (CPT) Codes Verywell (Note about the AMA's income from CPT codes: The amount the AMA makes from CPT codes each year is in dispute.) By continuing beyond this notice, users consent to being monitored, recorded, and audited by company personnel. CPT/HCPCS codes allowed for assistant surgeon reimbursement) to reflect annual code edits: o Added 54437 and 54438 o Removed 21810, 33332, 33472, 33960, 42508, 43350, MODIFIERS - Professional Claims - BCBSTX MODIFIERS - Professional Claims Effective 8/27/07 Blue Cross and Blue Shield of Texas/HMO Blue Texas accept all valid CPT and HCPCS Medicare does not recognize a registered nurse first assistant (RNFA) as a qualified Medicare provider. Modifier Description Role 80 Assistant Surgeon Provides full assistance to the primary surgeon and capable of taking over the surgery should the primary surgeon become incapacitated. 0000004643 00000 n %PDF-1.4 % <> This license will terminate upon notice to you if you violate the terms of this license. 21160 $2,679.94 End users do not act for or on behalf of the CMS. Department of Health & Human . 21198 $1,058.35 PDF Surgery: Cardiovascular System (surg cardio) - Medi-Cal 21343 $922.00 21120 $457.00 You, your employees and agents are authorized to use CPT only as contained in the following authorized materials: Local Coverage Determinations (LCDs), training material, publications, and Medicare guidelines, internally within your organization within the United States for the sole use by yourself, employees and agents. 80 - JE Part B - Noridian This section summarizes some of the rules. Procedure codes with a CMS assistant surgeon indicator of "2" are eligible for assistant surgeon reimbursement. This type of unbundling is incorrect coding. Assistant Surgeon/Assistant At Surgery Covered Procedures, Assistant Surgeon/Assistant at Surgery Covered Procedures system related to procedure codes allowed to be billed with either the 80 or AS modifier. 20973 $2,680.73 0000011084 00000 n Download AMA Connect app for 20605 $50.31 You now have the opportunity to claim CME credit for time spent reading the monthly Bulletin of the American College of Surgeons. Learn more with the AMA. 20910 $378.00 CPT Code Reimbursement 21122 $627.00 List of CPT/HCPCS Codes | CMS - Home - Centers for Medicare & Medicaid 21083 $1,358.00 In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material. Modifier 80 is appended to the surgical code when another surgeon is assisting at surgery. You are using an out of date browser. Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans, Reimbursement by Procedure Codes 20000 29999Effective Jan. 1, 2015. 20660 $182.49 endobj Users must adhere to CMS Information Security Policies, Standards, and Procedures. The CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. 0000002242 00000 n Modifiers 80, 81, 82, AS; Assistant at Surgery - Medicare Advantage; 9/2022. Blue Cross Blue Shield of North Dakota is an independent licensee of the Blue Cross Blue Shield Association, serving residents and business in North Dakota. All rights reserved. 20225 $112.94 0000006934 00000 n PDF MODIFIERS RECOGNIZED IN PROCESSING SERVICE CLAIMS iLLINOIS HEALTHCARE LICENSE FOR USE OF "PHYSICIANS' CURRENT PROCEDURAL TERMINOLOGY", (CPT) The outcome is to submit CPT modifier 78 with CPT code 49002. 20555 $269.83 What Is a CPT Code and Where Can You Find It? 633 N. Saint Clair St. Clinical Payment and Coding Policies | Blue Cross and Blue - BCBSIL <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> All procedures with a global period of ZZZ are related to another procedure, and the applicable global period for the ZZZ code is determined by the related procedure. 21086 $1,795.27 0000030598 00000 n AMA members get discounts on prep courses and practice questions. 29 0 obj Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans, Reimbursement by Procedure Codes 20000 29999Effective Jan. 1, 2015 This is determined through manual reviews. CPT Codes, Descriptors, and other data only are copyright 1999 American Medical Association (or such other date of publication of CPT). Up Next. Reimbursement Policies. Learn more about the process with the AMA. 21195 $1,240.00 Physicians who knowingly and willfully violate this prohibition and bill a beneficiary for an assistant-at-surgery service for these procedures may be subject to the penalties contained under 1842(j)(2) of the Social Security Act (the Act.) Valid indicators are: 0 = Payment restriction for assistants at surgery applies to this procedure unless supporting documentation is submitted to establish medical necessity. CPT Codes, Descriptors, , Surgery: Cardiovascular System (surg Cardio)Reimbursable for a second assistant surgeon. This information is a guide only; there may be circumstances where an assistant surgeon is necessary due to complications or unusual circumstances. OrthopedicCptCodeCheatSheet (2022) - sdslife.mindspacetech PDF 2020 CPT CODE ADDITIONS Effective January 1, 2020 2020 CPT CODE 21015 $403.66 0000002600 00000 n 0000070377 00000 n B. AS Non-physician provider as assistant at surgery: This modifier applies when the assistant at surgery services are provided by a PA, ARNP, or CNS. 20610 $59.00 Cross , Policy SAS01252012RP IMPORTANT NOTE ABOUT THIS REIMBURSEMENT CPT codes and descriptions are copyright 2010 American Reimbursement for surgical assistant services is based on whether the assistant is a Physician or other health care professional. startxref 2020 CPT CODE ADDITIONS 2 92202 One of the following ICD-10-CM diagnosis codes is required on the claim: B39.4, B39.5, B39.9, B58.01, . registered for member area and forum access, https://www.cms.gov/apps/physician-fee-schedule/search/search-results.aspx?Y=0&T=1&HT=0&H1=69990&M=5, https://www.cms.gov/apps/physician-fee-schedule/search/search-criteria.aspx, http://www.cms.gov/Medicare/Coding/ect=/NationalCorrectCodInitEd/NCCIEP/list.asp, http://www.cms.gov/Outreach-and-Edus/downloads/How_to_MPFS_Booklet_ICN901344.pdf, https://www.novitas-solutions.com/partb/reimbursement/mfsdbhelp.html, https://www.noridianmedicare.com/partb/fees/docs/2013/2013_mpfs_indicator_descriptors.pdf. startxref You must log in or register to reply here. 0000031389 00000 n Issue briefs summarize key health policy issues by providing concise and digestible content for both relevant stakeholders and those who may know little about the topic. 20670 $149.78 Medicare physician fee schedule database (MPFSDB) assistant at surgery payment indicators. First Assistant Not Payable Under Medicare for 2017 Page 2. The ACS maintains that a physician who assists with an operation should be trained to participate in and actively assist the . 21141 $1,251.79 Procedures with a global period of MMM are maternity procedures. Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans. These rates are provided for informational purposes only and are not to be considered a guarantee of payment.Actual payment will be based on Health Options policies, procedures, and Customer Benefit Plans. On June 30, 2009, within the post-op period of the cataract removal surgery, a YAG laser capsulotomy (CPT code 66821) was performed on the right eye. Evaluation & Management, Medicine, Physical Therapy. The reimbursement amount is dependent upon the assistant surgeon modifier appended to the surgical code submitted. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. These include preventive examinations represented by CPT codes 99381-99397. `[ELd}CGa= F(!V: =Q 0VB5 W5*WuU}8-cPZ99%t/50 <>stream 20912 $457.99 1 = Statutory payment restriction for assistants at surgery applies to this procedure. 32 0 obj Surgeon who participated as an assistant to a surgeon All Rights Reserved to AMA. BCBSND retains the right to review and update its reimbursement policy guidelines at its sole discretion. 20979 $22.00 Physician assistant at surgery: Service performed by a medical doctor (MD) use modifier -80. A TAR is required for the primary surgeon and assistant surgeon services are not reimbursable. 0000004173 00000 n Assistant at surgery may not be paid. Coding and Billing Guidelines | Provider | Premera Blue Cross 21248 $1,135.13 Some of the Provider information contained on the Noridian Medicare web site is copyrighted by the American Medical Association, the American Dental Association, and/or the American Hospital Association. 20920 $373.77 Residents and fellows deciding on a practice setting should be armed with all the relevant details. Article. endobj All Rights Reserved. 0000020908 00000 n Tagged as: AMA Current Procedural Terminology, CPT codes, Physicians as Assistants at Surgery, specialty surgical organizations, Bulletin of the American College of Surgeons