General Surgery Coding Alert
Here's How to Avoid the Modifier -62/Modifier -80 Mix-Up
When acting as co-surgeons, the two surgeons operate on the same patient but, in fact, work independently of one another. In other words, each surgeon performs a distinct portion of a single reportable procedure.
For example: A general surgeon and gynecological surgeon work together during pelvic exenteration. The general surgeon performs the approach, removes the bladder and a portion of the colon and performs colostomy, while the gynecologist completes the remainder of the procedure.
Because each surgeon performed a distinct portion of a single identifiable procedure, each should report 58240 (Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube[s], with or without removal of ovary[s], with removal of bladder and ureteral trans-plantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof) with modifier -62 (Two surgeons) appended.
By contrast, you should use modifier -80 (Assistant surgeon) to describe the presence of a second physician in the operating room who acts as an extra pair of hands to assist the primary surgeon.
As noted in the example on page 38, a general surgeon and a neurosurgeon may work together during spinal instrumentation placement, such as 22842 (Posterior segmental instrumentation [e.g., pedicle fixation, dual rods with multiple hooks and sublaminar wires]; 3 to 6 vertebral segments). During the procedure, the general surgeon assists the neurosurgeon but does not perform any portion of the procedure himself. Therefore, he should report 22842-80 rather than 22842-62.
Note: Most payers reimburse assistant surgeons at 16 percent of the regular fee schedule amount.
Remember: If two surgeons of different specialties work together during the same operative session but each performs a distinct, separately identifiable procedure, you would consider this "sequential surgery," and each surgeon may bill independently, with no modifiers appended.
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