Orthopedic Coding Alert

Question: I assisted another surgeon during part of a patients total hip replacement, but I didnt stay for the entire procedure. I appended modifier -80 to the claim, but when we self-audited recently, I second-guessed this modifier choice. Did I code the claim accurately?

New Hampshire Subscriber


Answer: Based on the information you provided, you probably should have appended modifier -81 (Minimum assistant surgeon) instead of modifier -80 (Assistant surgeon).
 
Modifier -80 is the most common of the assistant surgery modifiers (which include -80, -81 and -82, Assistant surgeon [when qualified resident surgeon not available]), but modifier -80 is not appropriate for your particular scenario.
 
You should report modifier -80 if you act as the primary surgeons extra set of hands. For instance, if you assist a neurosurgeon during a lumbar laminectomy (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), the neurosurgeon should report 63047, and you should report 63047-80.
 
According to the September 1992 CPT Assistant, you should choose modifier -81 if during the operation a minor problem is encountered that requires the service of an assistant surgeon for a relatively short period of time.
 
If the primary hip replacement surgeon requires your help during a portion of the surgery (such as fixation), you should append modifier -81 to 27130 (Arthroplasty, acetabular and proximal femoral prosthetic replacement [total hip arthroplasty], with or without autograft or allograft).