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Answer: In this case, each surgeon performs a distinct procedure as appropriate to his or her area of specialty, without aid from the other surgeon, i.e., a "sequential" surgery, not a cosurgery. Therefore, both the neurosurgeon and orthopedic surgeon should report his or her portion separately, even though all procedures were performed using the same incision and closure. Neither modifier -62 (two surgeons) nor -80 (assistant surgeon) applies in this case.
The neurosurgeon should code 63047 (laminectomy, facetectomy and foraminotomy [unilateral or bilateral with decompression of spinal cord, cauda equina and/or nerve root[s], [e.g., spinal or lateral recess stenosis], single vertebral segment; lumbar) for the decom-pression at the first level and 63048 for each additional segment, cervical, thoracic or lumbar (be sure to bill for each segment, not each interspace). No other modifiers are needed.
The orthopedic surgeon would report the fusion and bone grafts independently, using 22612 (arthrodesis, posterior or posterolateral technique, single level; lumbar [with or without lateral transverse technique]) and 20937 (autograft for spine surgery only [includes harvesting the graft]; morselized [through separate skin or fascial incision]). Again, no modifiers are needed. |
