Surgeon B performing an add-on

malissagiles

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Can anyone tell me how to code and bill the following scenario?

Procedure: C4-C5 ACDF (22551, 22845, 20931)

Surgeon A performs the diskectomy and the fusion with bone graft (22551, 20931), then he leaves. Surgeon B then comes in and places the anterior instrumentation (22845).

Surgeon A is reporting 22551 and 20931
Surgeon B: ?

22845 is an add-on code and cannot be reported by itself. How should surgeon B report this to the payer?

TIA!
 

malissagiles

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Any thoughts or suggestions on this anyone?

Can anyone tell me how to bill/report the following scenario?

Procedure: C4-C5 ACDF (22551, 22845, 20931)

Surgeon A performs the diskectomy and the fusion with bone graft (22551, 20931), then he leaves. Surgeon B then comes in and places the anterior instrumentation (22845).

Surgeon A is reporting 22551 and 20931
Surgeon B: ?

22845 is an add-on code and cannot be reported by itself. How should surgeon B report this to the payer?

TIA!
 
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Co surgery?

This is NOT my area of expertise (You might want to post question in the orthopedics forum thread) ... but ...

Are they both in the same specialty & same practice? Then, for all intents and purposes they are the same physician. Code everything to one physician and take the adjustment on the back end.

Are they different specialties? (Neuro & Ortho perhaps?) Code both the arthrodesis and the instrumentation to both surgeons as co-surgeries. Each will be paid a reduced portion.

Those are about the only ideas I can think of.

Hope that helps.

F Tessa Bartels, CPC, CEMC
 

jmcpolin

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The instrumentation is part of the fusion so I would think that phys b needs to assist with the arthrodesis part in order to bill the instrumentation
 
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