Neurosurgery Coding Alert

In the December issue of Neurosurgery Coding Alert we reported on a new modifier (modifier -60) for coding altered surgical fields; however, HCFA has announced that it should not be used. Instead, they advise billers for Federal programs (e.g., Medicare and Medicaid) that any unusual circumstances encountered in a surgery should continue to be billed with modifier -22 (unusual procedural services).

The AMAs intent in issuing modifier -60 was to indicate when surgery was complicated due to limited access to the surgical site. Many private carriers will still accept modifier -60, however, any Medicare claims should be appended with modifier -22.

HCFAs Program Memorandum B-00-75 stated that verification of the status of an altered surgical field would be difficult for their contractors, requiring manual review on almost all claims submitted with modifier -60. They also noted that some codes already describe complex circumstances.

Source: HCFA Program Memorandum B-00-75.