Assistant Surgery Guidelines
Effective December 1, 2011, BCBSNE began following CMS’s Post-Op and Assistant Surgery Policy. This policy, updated annually in November, can currently be found online at cms.gov.
CPT codes with an indicator of 2 allow an assistant. CPT codes with indicators 0, 1, and 9 in the assistant surgery column do not allow payment for assistant surgeon.
If the CMS indicator is 0 and the service is denied, you may submit an appeal along with the appropriate medical record documentation and the claim will be reviewed.
Electronic Remittance Remark Code Lists
Fee schedules are not published online at this time, please contact your Health Network Consultant for more information.