General Surgery Coding Alert

Reader Questions:

2 Surgeons Don't Always Lead to 62

Question: One of my doctors was called into the operating room to do a vascular repair. Apparently, this patient was having a breast reconstruction done and she was found to have a lot of scarring from the radiation. During the takedown of that scarring, the axillary vein was nicked. It was at this point that my physician was called in as a vascular consult and did the repair of the axillary vein. How should I report this procedure? Illinois Subscriber Answer: You should report code 35206 (Repair blood vessel, direct; upper extremity) for your surgeon's repair of the axillary vein. The primary indication for performing procedure code 35206 is to repair a vessel that has been injured as a result of direct trauma. Pointer: You also need to find out if this is a co-surgery case or if you should just be billing for your vascular surgeon's work. Check your surgeon's documentation. Most likely you-ll just report 35206 with no modifier. If, however, this is a co-surgery case, you will need to append modifier 62 (Two surgeons). When two surgeons work together to perform distinct portions of a procedure CPT identifies with a single reportable code, you-ll need to access modifier 62.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in Revenue Cycle Insider
  • 6 annual AAPC-approved CEUs
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more