Otolaryngology Coding Alert

Question: I am receiving denials for code 62165 endoscopic pituitary tumor excision when my ENT and a neurosurgeon bill as co-surgeons stating co surgeons not warranted. How should we be appealing to get reimbursed? Any assistance is greatly appreciated.

Nevada Subscriber

Answer: Keep these points in mind before reporting a procedure as co-surgery:

• Co-surgery is when one surgeon performs the first part and a different surgeon performs the second part of the same procedure.
• Co-surgery typically is seen with an anterior approach for spinal procedures. It would be extremely rare for an endoscopic procedure to require this type of treatment.
• You must have two independent notes from each surgeon detailing their individual part and indicating at what point they handed off or received the patient.

Once you have your two different op notes, write an appeal and include that the Medicare Fee Data Base indicates that this procedure is listed as a procedure that qualifies for co-surgery, qualifying for the 62 (Two surgeons) modifier.