surgical assistant billing question

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surgical assistant billing question

Post by bel915 » Fri Aug 03, 2012 11:54 am


I got a call from a potential client that is a certified surgical tech. He claims that he does his own billing for his services in assiting surgeons in surgeries. I've been doing billing for about 10 years now and i honestly haven't heard of surgical techs billing for their services. He faxed me an eob to show me one of the CPT code that was billed for his services and it got paid to him.

It showed CPT code - 43281 (Laparoscopy, surgical, repair of paraesophageal hernia, includes fundoplasty, when performed; without implantation of mesh) with modifier - AS.

He does have a NPI under his name and a TAX ID.
Is this possible? I don't want to do business with him if this is illegal in anyway.


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Gavin Walker
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Re: surgical assistant billing question

Post by Gavin Walker » Fri Aug 03, 2012 1:25 pm

This looks legitimate, but not all insurance may cover this. As long as the surgical assistant knows what insurance will cover the service before performing the procedure, you should be good to go. You might also look into whether this is a first assistant or a second assistant. As you might guess, the rules are even more strict for a second assistant.

Good luck, and post back anything else you find out.
Gavin Walker
Walker Tek Solutions, LLC

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Re: surgical assistant billing question

Post by mcasey » Fri Oct 12, 2012 12:36 am

I do not think that it will be secure to start business with him. I have never heard of such billing. Still, if you you want to do business with him carry out all the verification and be sure before starting it.


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Re: surgical assistant billing question

Post by emmahunter588 » Mon Dec 10, 2012 9:24 pm

I am not sure if it is wise to engage in business with him. If you are not sure then don't. There are a lot of other businesses that makes use of medical billing software out there.

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Location: Georgia

Re: surgical assistant billing question

Post by ephillip » Mon Feb 11, 2013 3:43 pm

Ive been billing for First Assistants for years. As long as they have a valid Tax ID, NPI, AND the surgeon is willing to provide the info needed to bill the same codes.

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