Assistant Surgeon Invoices
The Invoices screen for Surgeons has an Assist check box which should be
ticked for Assistant claims. Uncheck the Assist box for other claims,
such as consultations and non-surgical procedures, or if you are the
primary surgeon.
NOTE: You don't need to enter the Assist Item (eg
51300, 51303, 51306, 51309). Cutting Edge determines this for you as you
enter the surgeon's items in the Items section.
- Select the Surgeon and Hospital from the drop down lists. If you've
entered different provider numbers for each hospital, the correct one
will be shown as you change the hospital.
- Enter the surgeon's items in any order. Cutting Edge will sort them
for you, apply the appropriate Multiple Operation Rule (e.g. for MBS
100% of the item with the largest fee, 50% of the second item, 25% of
subsequent items), calculate the fee based on the rules for the selected
fund and show the Assist Item in the Fee Calculation box.
- NOTE 1: Where the total MBS fee for the surgeon's items is
below the threshold specified in the MBS (with Multiple Operation Rule
applied), then the Assist item is 51300 and the Assist Fee is a fixed
fee, displayed against the first item. Because the second item does not
take the total over the threshold, and therefore does not affect the
Assistant Fee, it displays a $0 value.
- You will also see the text update in the Service Text box. This is
how we communicate the operation details to Medicare and Funds on
Assistant claims.
The software can only send one item (the Assist Item) with a date, a fee
and the Service Text. None of the text in Descriptions on each surgical
item gets sent. Due to limitations at the Medicare hub, Service text is limited to 50 characters (100 for DVA). This becomes challenging when there are more than 6 surgical items on one invoice.
Edit the Service Text with caution! If surgical details are missing the
claim will be rejected or underpaid. Cutting Edge will warn you if the
Service Text is too long to transmit.
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