Wiki Pain management Question- 2 Docs performing procedures during same session

[erinal]

Hello all! I need some help. I work for a pain management clinic and one of our Dr's is going to perform a stim trial on a patient during a laminectomy that will be performed by a different Dr. SO...how do we code this? We will be performing the 63650 and the other dr will be performing the 63655 during the same session and the patient will be inpt. I was thinking both my dr and the other dr's office needs to bill both codes and then append the appropriate modifiers? The other Dr will be performing most of the work since he will be following him during his inpt stay...and I don't know much about inpt coding and how that goes. We have never collaborated with another Dr before and never under these circumstances. Your assistance is appreciated!

 

[danskangel313]

I know there are two separate providers, but... 63655 bundles with 63650 (a mod is allowed). 63650 does not allow for a co-surgeon or an assistant surgeon, but 63655 does. Would a 59 be appropriate for the situation if only one provider was involved? As long as there is justification to add the 59 to 63655 (not for the reason that it was a separate provider), then that makes me wonder if you could bill 63655 with an assistant or co-surgeon mod + the 59. Is there a better CPT code that could work?

I initially though about XP, but the guidelines state "Documentation indicates the services were provided by different practitioners with the same specialty in the same group practice."

Regardless, 63655 can only be billed by one provider, so there's no options to mull over as far as mods go.

 

[mhstrauss]

Is the other doctor performing the lam specifically for the stim implantation (I'm assuming yes)? If yes, then I would be weary of using both codes; essentially, both docs would be performing a part of 63655, in which case they should both use that code, with mod 62. I agree with other points made by previous poster.