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Thread: Neurosurgery and Orthopaedics doing spinal fusion together

  1. #1
    Join Date
    Apr 2007

    Default Neurosurgery and Orthopaedics doing spinal fusion together

    AAPC: Back to School
    Neurosurgery and Orthopaedics do a co-surgery of a spinal fusion. Our Neurosurgeon does the decompression and then as co-surgery they do the fusion, and instrumentation with Ortho. For billing, we currently bill the Neurosurgeon the decompression (63001), then the fusion as a co-surgery (22590 mod 62), and not the instrumentation. Ortho bills the fusion as a co-surgery (22590 mod 62) and they also bill the instrumentation (22840). My question is even though the instrumentation can't be billed as a co-surgery, can actually bill the Neurosurgeon as an assistant?

  2. #2
    Join Date
    Apr 2007
    North Carolina


    According to CMS, 22840 has a payment status indicator of 1 for co-surgery.

    Co-surgery 1=Co-surgeons could be paid, though supporting documentation is required to establish the medical necessity of two surgeons for the procedure.

  3. #3
    Join Date
    Apr 2007


    Thank you so much!

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