General Surgery Coding Alert

For 2003, CPT revises the instructional text accompanying codes in its "Spine (Vertebral Column)" section (22100-22855) to reflect new surgery guidelines.

Specifically, previous versions of CPT have instructed, "Do not append modifier -62 [Two surgeons] to spinal instrumentation codes 22840-22855." For 2003, these instructions have changed, stating, "Do not append modifier -62 to spinal instrumentation codes 22840-22848 and 22850-22852."

Interpreted strictly, this means that two surgeons (for instance, an orthopedic surgeon or neurosurgeon and a general surgeon) may work (and bill) as co-surgeons during reinsertion of spinal fixation device (22849) or removal of anterior instrumentation (22855), as long as both surgeons work together as primary surgeons, says Eric Sandham, CPC, compliance educator for Central California Faculty Medical Group, a group practice and training facility associated with the University of California at San Francisco in Fresno. Look to future editions of General Surgery Coding Alert for a complete discussion of co-surgery and assistant surgeon billing guidelines.