cystocele and rectocele repair by 2 different physicians

[esummers]

What is the correct way to code cystocele and rectocele repair, one done by gynecologist one done by urologist. We have tried 57250 and 57240 separately, with the other billing the assist code. We have also tried each physician doing 57260 with a modifier 62. Medicare doesn't seem to like either way we do it.

 

[ajs]

What is the correct way to code cystocele and rectocele repair, one done by gynecologist one done by urologist. We have tried 57250 and 57240 separately, with the other billing the assist code. We have also tried each physician doing 57260 with a modifier 62. Medicare doesn't seem to like either way we do it.

It does depend somewhat on exactly how the procedure was accomplished. Also in order to use the 62 modifier, each physician has to dictate a separate op report for their part of the procedure. If both were accomplished with a vaginal approach, then the 57260 -62 would be the accurate way to code. Otherwise, one surgeon is primary and one is assistant, just depends on the documentation.