Wiki Co-Surgeon or Assistant for Robotic Assisted Lap Prostatectomy

[sls]

I can't seem to find any information regarding coding for the second surgeon with a robotic assisted procedure. I am leaning towards assisant surgeon, however, some clinicans disagree. Does anyone know?

 

[emcee101]

With a co-surgeon, the two providers each have to perform distinct parts of the same procedure. The documentation HAS to clearly support this being done. They are each required to have separate operative notes clearly dfining what part of the procedure they performed. You would send a claim for each physician with the same DX and CPT code and use modifier 62 on each cpt code. You should increase your billed fee by 125%, as most plans will increase the allowable fee by 125% and then split it between the two surgeons, 62.5% each.

if a second doctor acts as an assistant to the primary surgeon, then you should report with modifier 80 for assistant surgeon on the claim for the assistant, and no modifier on a separate claim for the primary surgeon. If the assistant is a PA or NP, you would use modifier AS instead. You would not increase your fees on either claim. The primary should be reimbursed at 100% of the allowed amount, and the assistant will be reimbursed at 16% of their usual fees. IF the assistant is an NP or PA, they are reimbursed at 85% of the 16%.

Here's info on correct modifier use from CMS

Modifier 80, 81, 82, AS - http://www.wpsmedicare.com/j8macpartb/resources/modifiers/assistsurgerymodifiers.shtml

Modifier 62 - http://www.wpsmedicare.com/j5macpartb/resources/modifiers/modifier62.shtml