Neurosurgery Coding Alert

Question: During the surgical portion of stereotactic brachytherapy, my neurosurgeon and radiation oncologist worked side-by-side, with the surgeon performing the localization and access and the oncologist placing the radioactive seeds. Should I use modifier 62 when reporting the neurosurgeon's work?


Georgia Subscriber

Answer: No. Modifier 62 (Two surgeons) is not appropriate in this case. The neurosurgeon and radiation oncologist are not co-surgeons as defined by modifier 62, but rather each works independently during distinct and separate portions of the procedure and dictates his own operative report, etc.

Important: When two surgeons of different specialties each perform distinct, separately identifiable procedures during the same operative session, you should consider this -sequential surgery,- and each surgeon may bill independently, without appending any modifiers.

Therefore, you should report the neurosurgeon's portion of the surgery using 61770 (Stereotactic localization, including burr hole[s], with insertion of catheter[s] or probe[s] for placement of radiation source) with no modifiers attached. The radiation oncologist must implant the seeds because he is the only one trained and approved for handling radioactive substances in a clinical setting, and he will bill independently for his portion of the procedure.