Otolaryngology Coding Alert

Question: A neurosurgeon performs craniectomy with an otolaryngologist for the excision of an acoustic neurofibromatosis. Should I code this as co-surgery?

New Jersey Subscriber

Answer: If the otolaryngologist and neurosurgeon share a single approach and single CPT code for the main surgery, they should use the same code appended with modifier 62 (Two surgeons). In your case, both surgeons share the craniectomy with excision of acoustic neurofibromatosis (237.72, Neurofibromatosis, type 2 [acoustic neurofibromatosis]). Therefore, you and the neurosurgeon should each submit 61530-62 (Craniectomy, bone flap craniotomy, transtemporal [mastoid] for excision of cerebellopontine angle tumor; combined with middle/posterior fossa craniotomy/craniectomy).

Submit the claim electronically and set your fee at 125 percent as a co-surgery, and you might not even have to send in a supporting file. The 2008 Medicare Physician Fee Schedule designates 61530 with a co-surgeon status of "2," which means reporting the code as a co-surgery does not require documentation if the surgeons are in different specialties, as is the case with the scenario you describe. Medicare pays each surgeon 62.5 percent of 61530's payment or approximately $1,758.23 (73.86 relative value units x 38.0870 = $2,813.1723).