Surgeon Companion Claims

When the autocoder codes an anesthesia case, it can also produce the surgeon-side output for the same encounter. HANK CODES calls this output a companion. The companion carries the surgical CPT lines with the surgeon as the rendering provider. It arrives with the anesthesia claim from the same run, so a coder reviews both together.

The feature ships off. Your organization must enable it. Contact your Hank representative to turn it on.

What a companion contains

A companion holds the surgeon professional-fee content for the encounter:

1. The surgical CPT lines, each with the surgeon as rendering provider.
2. Diagnosis pointers on each line.
3. Payment and informational modifiers, for example 50 for a bilateral service, 62 for a co-surgeon, 80 or AS for an assistant, and PT or 33 on a screening conversion.
4. Units, after the autocoder applies MUE ceilings and multiple-endoscopy rules.
5. The note text that supports each line, so a coder can confirm the code against the record.

Two modes

Your facility configuration sets companionClaims.SURGERY.mode.

• worksheet (the default): codes plus supporting evidence for coder review. A worksheet is never a billable claim.

Your configuration also controls which procedure families the autocoder codes on the surgeon side, through companionClaims.SURGERY.familyAllowlist. The base list covers GI endoscopy, cataract, OB delivery, general-surgery staples, orthopedic staples, and cystoscopy. The autocoder refuses a procedure outside the list and raises an alert instead of coding it without rules. Contact your Hank representative to change the list, the mode, or the document gate.

Alerts on companion output

Companion alerts carry the surgeon_companion_ prefix. Every one of them fires only while the feature is enabled. Two examples:

• surgeon_companion_source_doc_refusal reports that claim mode found no signed surgeon procedure report. The autocoder produced no companion claim. The anesthesia claim is unaffected.
• surgeon_companion_screening_modifier_missing asks a coder to confirm a government-payer screening line that carries no PT modifier.

Two alerts compare the two outputs and attach to both. surgeon_companion_dos_mismatch fires when the companion procedure date does not agree with the anesthesia date of service. surgeon_companion_screening_story_mismatch fires when only one of the two outputs tells a screening story, for example a screening companion with no Z12.11 on the anesthesia claim. Both are HARDSTOP alerts with a high default severity.

surgeon_companion_status appears on the anesthesia claim on every enabled run. It summarizes how many companion outputs the run built, how many lines it excluded, and how many errors or review items it recorded.

A companion build never changes the anesthesia claim. The autocoder isolates a companion failure, records it, and returns the anesthesia claim as usual.

How this reaches you

What happens next depends on how your organization consumes HANK CODES. In HANK Claim Maker, a HARDSTOP alert places the claim in the review queue your administrators configured for it. Organizations that consume the coding API directly decide in their own workflow which alerts pause a claim, who reviews them, and when a claim is released.