2 surgeons

cannspurr

Contributor
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My doctor did surgery with a general surgeon on a patient with ca ovary.
The general surgeon opened and closed the patient, did a omentectomy, pelvic lymph node sampling , lysis of extensive pelvic adhesions, umbilical hernia repair( my doctor assisted). We did the abd hyst bso.
Do I code the hyst bso with modifier that services reduced because he did not open and close, and bill the asst fee for the other parts of the surgery or do I code the entire surgery as one code{ total procedure all together instead of breaking down the pieces} and modify it for 2 surgeons??
I do not want it to be considered unbundling.
 

Kris Cuddy

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As long as the primary surgeon does not participate in a residency program with the hospital, and the operative report supports him being the assistant surgeon, your surgeon may and should bill for his services.

If she/he does participate in a residency program, verify there was no qualified resident available and bill with modifier 82.

Are you able to access the actual operative reports? If so, it may be in your best interest to review those to verify your surgeon assisted through the entire surgery. If your surgeon did assist through the entire surgery, both the primary surgeon and your surgeon's claims should match in the services and diagnoses billed. The modifier for your surgeon is what will differentiate the claims and amount of reimbursement.

No matter what code(s) you end up billing, use either modifier 82 as above, or modifier 80 if he was an assistant surgeon.

Good luck,

Kris
 
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