Co-surgeon on inclusive part of a larger case

[missyah20]

Good Afternoon -

I have a case where Surgeon A is performing a Lap Pyeloplasty and has asked Surgeon B to be in the OR for the Laparoscopy due to prior mesh placement by that surgeon (surgeon B).

Surgeon B has documentation of the initial laparoscopy and after they gain access and review mesh placement, etc Surgeon B leaves and Surgeon A finishes the case.

Is the work done by Surgeon B billable?

Thanks!

 

[thomas7331]

It is hard to judge this without seeing the operative report and without knowing the specialties of the two surgeons, but this does not sound like a co-surgeon case by my understanding - it sounds like a single procedure in which each surgeon has just done a portion. For this procedure, Medicare will only allow co-surgeons in cases where the documentation supports the medical necessity of two surgeons, and for a co-surgery Medicare also requires the two surgeons to be of different specialties. If your documentation meets these requirements, you may be able to get payment for both physicians' services. But if this was an arrangement just done for the convenience of the physicians and not due to the needs of the patient, and the surgery could have been performed by a single physician, then the work of the second surgeon is not likely billable.