Neurosurgery Coding Alert

Check the work, not dictation, to prevent 42% or more in losses. With carriers paying 62 percent on co-surgery cases, 20 percent on assistant surgeries, and 15 percent for non-MD assistants, the wrong modifier can cut your pay big time -- meaning you better keep certain rules in mind. The hang-up: "Choosing between the co-surgery and assistant surgeon modifiers can be a confusing matter because physicians often do not understand the difference themselves," says Beth Thomsen, department billing coordinator for Neurosurgery/Plastic and Reconstructive Surgery with University of Toledo Physicians LLC. "One surgeon may dictate an operative report as though it's a co-surgery, but the supposed co-surgeon feels that he or she acted as an assistant only." Solution: Focus on what the physician did during the case and the physicians' coordination and documentation, Thomsen recommends. Read on for tips on ensuring the surgeon's work -- not his dictation -- leads you in the right [...]