Billing assistant (suffix B) codes

Alex Dong asked about suffix B billing to the MOH. He was directed to Trillium, and here is their response. If you have any questions, please contact Trillium directly.

Thanks

From Alex:

I have a billing question. Some of my colleagues working at other centres have mentioned billing assistant (B suffix) codes for procedures like fracture reductions. I know that we do bill anesthesia codes (C suffix) when procedures require sedation, but often procedures do require 2 people to safely complete. I haven’t heard of anyone here billing the B suffix codes. Wondering if you knew anything about this.

Trillium’s response:

Billing for assistants is allowed but the code being billed must allow for assistants. Not all codes can be billed with suffix B. If there are Basic Units in the Asst Column beside the code in the Schedule of Benefits, then yes, you can bill as an assistant.

Typically the Open Reduction Fracture codes allow for Assistants but lately MOH requires DOCUMENTATION for Open Fractures in the ER . Keep that in mind when billing Open Fracture Codes. It is easier to submit the documentation at the time rather than have to go back and get it for us.

Trilllium’s follow up to their response:

Follow up. For documentation for open fractures, this is what they said:

We can’t send a copy of the chart to MOH as it does not copy well and the hand writing can be difficult to read. They need something in writing that this was indeed an open fracture in the ER. Just send us an email explaining some details for us to print. That should be good enough.