# Co-surgeons vs assistants



## AlaskanCoder (Mar 19, 2014)

I have a situation where one surgeon did a laparascopic appendectomy CPT 44970 and documented that the other surgeon assisted him and then the other surgeon did procedures on the ovary which her coder has coded as 58662 and 58350.  The 1st surgeon states in his documentation that he assisted on the gynocological procedures and that the other surgeon (2nd surgeon) seperately documented her portion of the surgery. 
The 2nd surgeon documented that the incision was made by the 1st surgeon and the ports placed, gloves were changed "after which the adominal procedure had been started." she states the appendectomy was performed by the 1st surgeon, after which she began the the ovarian procedures. 
They both documented the closure of the incisions. 

My question is should these be billed as cosurgeries or as indedendent sugeries with assists?  It doesn't seem like what I usually see as cosurgeries, but it doesn't seem like the primary for each should procedure should be looked as if these were two different operative sessions. 

Thank you for any advice, 
Karen Hill, CPC, CPB, CPMA
AHIMA Approved ICD-10-CM Trainer


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## Emmy1260 (Mar 19, 2014)

I'm interested in what others have to say about this. I recently had the same situation. 

GYN did lap hyst, Gen Surgeon did lap abdominal procedure. GYN assisted Gen Sur. There is a code edit with the 2 procedures. We billed the GYN assist with an -80, which was denied due to the code edit. It was then rebilled with -22. Waiting to see how this pans out. 

We debated on whether to bill this with surgical team as well.


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## mitchellde (Mar 20, 2014)

These are surgeon and assistant surgeon scenarios.  Co- surgeons are when both surgeons are performing different parts of the same procedure.  You may have received a denial if the procedure did not require the presence of an assistant.  Not every procedure allows you to bill an assist.  You would not call these co-surgeries as each provider performed distinctly different procedures.


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## AlaskanCoder (Mar 20, 2014)

Thanks, Debra, that was were I was leaning. 

Karen


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