Neurosurgery Coding Alert

When trying to decide between modifiers -62 (Two surgeons) and -80 (Assistant surgeon) when more than one surgeon takes part in performing a single identifiable procedure, the most important question to ask yourself is "Did the surgeon serve as a primary surgeon for at least a portion of the shared procedure?" If the answer is "yes," you should turn to modifier -62.
 
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.

By contrast, you should use modifier -80 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. For example, an orthopedic surgeon and a neurosurgeon may work together during placement of spinal instrumentation (that is, 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 orthopedic surgeon assists the neurosurgeon but does not perform any portion of the procedure himself.

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.