Wiki S2900

[BS&SC]

Has anyone ever been reimbursed for the use of Robotic Assist during a hysterectomy (58571). Our office sends this through all the time and it never gets reimbursed. Is there any hope?

On a separate note, provider A & B, both under same Tax ID, sent me a charge for a RATLH they did where one started surgery, then turned console over to Provider B to do a small portion, with original Provider then finishing procedure. Is this an 81 modifier? No medical necessity established, so it made me wonder if it was done because Provider A lacked the experience that Provider B had.

 

[csperoni]

I have never seen S2900 paid. In fact, our system has it as $.01 fee just used for tracking purposes. In my opinion, I don't have an issue with S2900 not paying as the physician is not incurring any additional expenses by using the daVinci vs traditional laparoscopic.

Regarding 58571 by 2 providers. IF they are different specialties, AND there is a necessity, co-surgeons (-62) may be appropriate. If they are both the same specialty, then you will have to submit one as primary and the other as assist. -81 is for minimal assistant surgeon (typically if assistant was not there during the entire procedure) which does not seem to be what you are describing. Assistant surgeon for a hysterectomy is considered always appropriate for an assistant, and you should not need to establish medical necessity. It is standard practice in a major surgery like that to always require an assistant. Based on the information provided, I would suggest:
Dr. A: 58571
Dr. B: 58571-80

 

[natashalage]

Thank you very much Christine for explaining it to us. I am learning modifiers when 2 MDs are listed in Op note. Could you please teach me how to code in these 2 cases? and Thank you in advance!
Case #1. The Op note is written by GYN MD who did a major surgery. She listed MD2 who is Oncologist ( different specialty) as Assistant. There is no mentioning MD2 in the body of the Op note. Will we code for MD2 with a modifier 80/82?
Case #2. Same Op note but now MD1 lists MD2 as Co-surgeon without any additional information, same note, one Op note by MD1.
I think: case #1 to code for MD2 but not for case 2.

 

[nielynco]

Thank you very much Christine for explaining it to us. I am learning modifiers when 2 MDs are listed in Op note. Could you please teach me how to code in these 2 cases? and Thank you in advance!
Case #1. The Op note is written by GYN MD who did a major surgery. She listed MD2 who is Oncologist ( different specialty) as Assistant. There is no mentioning MD2 in the body of the Op note. Will we code for MD2 with a modifier 80/82?
Case #2. Same Op note but now MD1 lists MD2 as Co-surgeon without any additional information, same note, one Op note by MD1.
I think: case #1 to code for MD2 but not for case 2.

In the case of co-surgeons, each MUST document what they did and should also mention the other surgeon. If they are surgeon and assistant, the assistant need only be mentioned by name in the heading - no description of their work is required in the body of the op note.

 

[brenda long]

In the case of co-surgeons, each MUST document what they did and should also mention the other surgeon. If they are surgeon and assistant, the assistant need only be mentioned by name in the heading - no description of their work is required in the body of the op note.

Why is coding Assistant at Surgery for OB/GYN different than coding Assistant at Surgery for Ortho or Neurosurgery? What qualifying documentation can you share with me?

 

[nielynco]

Why is coding Assistant at Surgery for OB/GYN different than coding Assistant at Surgery for Ortho or Neurosurgery? What qualifying documentation can you share with me?

Can you explain what differences you are referring to? Co-surgery for a delivery is not possible if the ob is reporting a global code because the co-surgeon cannot also report the global code as he only did a portion of the cesarean (or complicated vaginal delivery in some cases). Documentation would be required by each physician as they are asking to be paid for a portion of the surgery, rather than just assisting as an extra pair of hands.