Wiki Assistant to surgeon or co-sugeon

[melissab74]

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An OB GYN surgeon is performing a hysterocopy which resulted in a perforation of the uterus and the General Surgeon is called in to perform a diagnostic laparoscopy to look for any bowel perforations. During the procedure, minimal adhesiolysis was performed by the General Surgeon and the two laparoscopic port sites were closed by the primary OB GYN surgeon. I am not sure whether to bill this as assistant to surgery or co-surgeons. My initial thought was to code the primary hysteroscopy with the 62 modifier for both surgeons.

Thank you

 

[csperoni]

I would call this 2 different surgeries - not co-surgeons. The general surgeon was not even present during the hysteroscopy work. And your ob/gyn can't bill for additional work to check or correct a problem he/she created.
I would bill the ob/gyn for hysteroscopy 58558 (or other hysteroscopy code 58558-58565 if other work done) and the general surgeon for the laparoscopy 49320.
I would only bill an instance like this as co-surgeons if each physician did a component of a larger procedure. Example: plan is for total abdominal hysterectomy and bilateral salpingo-oophorectomy. Dr. A removes the uterus & cervix and has difficulty or a complication removing the tubes & ovaries and calls in Dr. B who removes the tubes and ovaries. Then you have 58150-62 for both surgeons.