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  • Can We Bill Medicare for an Assistant Surgeon

    Are we able to bill Medicare for an assistant surgeon for 68720 Dacryocystorhinostomy?

    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.