Wiki Co-Surgeon/Assistant

[kimberlyapetro]

I could use some help with modifiers. I am coding for a neurosurgeon with an ENT co-surgeon and a NP assistant.

The ENT does a anterior approach than leaves the surgery. He does not close. The neurosurgeon and the NP complete the case.

He performs a corpectomy at C7 with an anterior interbody arthrodesis at C5-C6, C6-C7, C7-T1.

Here is how we coded
63081
22551
22552
22845
22851 x 3
20930

Do we add the 62 to just the 63081 and then bill the AS on the remainder? Or should the ENT get credit for the arthrodesis as well? If so how do we add for the NP?

Thank you!!

 

[Peter Davidyock]

I do not believe that merely performing the opening qualifies as a distinct part of the procedure. How would you establish the medical necessity? The ENT could possibly submit with an 80 but I would be hard pressed putting a 62 on my claim for the neurosurgeon and reducing his/her payment just because someone else wants half of the surgical charge for performing the approach.