JUL 19, 2023
Can We Bill Medicare for an Assistant Surgeon
Are we able to bill Medicare for an assistant surgeon for 68720 Dacryocystorhinostomy?
Answer:
CMS does allow payment for an assistant with CPT code 68720. CMS has published which surgical codes are applicable for an assistant-at-surgery. Commercial payers may or may not follow the same coverage policy.
You can access the Medicare Physician Fee Schedule Database (MPFSDB) to determine if CPT modifier -62 two surgeons (co-surgeons) or -80 assistant to surgery are applicable to a particular procedure code. The Academy also includes a list in Chapter 5 of Fundamentals of Ophthalmic Coding or in the Coding Coach details per CPT code.