tci Medicare Compliance & Reimbursement - 2013 Issue 11

Billing: Nail Down PA Reimbursement In Four Expert-Tested Steps

Coding the assist shouldn’t be as tough as coding the procedure itself. Watch how you bill when PAs serve as first assistants during difficult surgeries. Your documentation will make or break your claim. Tip: Make sure you know which modifiers you need to append. Step 1: Check the Fee Schedule Each year, as part of the Physician Fee Schedule, Medicare publishes those procedures for which it approves technical surgical assisting (TSA) by a physician, physician assistant (PA), nurse practitioner, or clinical nurse specialist. If the Medicare Physician Fee Schedule lists a “1” or a “9” in...

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