Wiki How to bill 22558 for assistant surgeon?

[TBIBilling]

Our orthopedic spine docs routinely use an access surgeon when performing anterior lumbar interbody fusions. We always bill 22558 with a 62 modifier for our surgeon as does the access surgeon. However, I was wondering how other practices bill for the fusion for the assistant surgeon, if at all? We're receiving notification that our access surgeons' claims are being denied due to "multiple physicians are not covered." (i.e. our surgeon's claim and our assistant surgeon's claims were both processed and paid which causes the access surgeon's claim to deny). If we don't bill the fusion for the assistant surgeon, all other codes will deny due to no primary procedure. Has anyone run into this before??

 

[sxcoder1]

When I used to bill these, I billed 22558 with 62 for the cosurgeon and did not bill the assistant at all on that code. I did bill the assistant on any other codes where there was not a cosurgeon. They would all get paid.

 

[SMoose]

How to bill 22558 for Assistant surgeon with add on cpt code also?

Appreciate the info in the previous threads, but in our scenario the General Surgeon leaves the room after the main procedure of 22558 and the assistant is there for the applying of Spine Prosth Device 22853,22845 which are add on codes. We have billed the 22558 under the assistant with .01 and then the add on codes which some insurances have paid, but then there is some that will pay the .01 for the assistant and not the co-surgeon which we then appeal! Is there a better way to bill these codes for the assistant with a modifier or different technique since we cannot just bill for the add on codes?

Thanks for your time looking into this!!