General Surgery Coding Alert

Question: How do I code when one surgeon assisted another and modifier -80 (assistant surgeon) was used? The assistant surgeon was called in for a consultation regarding a different diagnosis a couple of days after the surgery. This happened again three days after a patient had removal of an ovary and repair of a bowel puncture. The patient developed an ileus so the assistant surgeon was called for a consult. These services all have global periods, and the surgeons involved were not the primary surgeons.

Telle Stafford
Mooresville, N.C.

Answer: Because the surgeon performed the original services as an assistant, there would be no global period involved unless the assistant surgeon and surgeon were in the same practice, says Susan Callaway-Stradley, CPC, CCS-P, an independent coding and reimbursement specialist in North Augusta, S.C. If they share the same tax identification number, the global period for the primary surgeon would affect the assistant surgeon because he or she is a member of the same practice. In that case, append modifier -24 (unrelated evaluation and management service by the same physician during a postoperative period) to the evaluation and management for the consult requested after the original surgery if the diagnosis is different.