Breast reconstruction; TRAM w/co surgeon (19364)

NPSDEB

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I did a search on procedure code 19364 for this thread and it looks like this question goes way back. We have had a few insurance companies deny the co-surgeons (62 modifier) for procedure code 19364 stating they are not of different specialties (two board certified plastic surgeons doing the case together). This is a lengthy procedure and to reduce anesthesia time; each surgeon performs the surgery on one side of the body. What is everyone's experience on getting this paid. Mine is all over the board! Of course, every claim needs to be appealed and explained as to why it needs two surgeons. We were wondering if each surgeon should just submit which side of the body they did (Dr A reports 19364.RT and Dr B reports 19364.LT... no 62 modifier?)

If you would rather contact me direct my email is dmiller@northlandplasticsurgery.com

Thank you-
Deb
 
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