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Thread: Help!

  1. #1
    Join Date
    Apr 2007
    Seattle First Hill Washington 20608

    Default Help!

    AAPC: Back to School
    I'm not surehow tohandle this type of coding situation and need assistance

    Dr. A and Dr. B did a surgery on a patient together on 12/18. Dr. B performed procedure 61548 on this patient prior to 12/18. She had complications with a cerebrospinal fluid leak and therefore the repeat surgery. The doctors were going to bill 61548 again as cosurgeons but they didn't do the excision of the pituitary tumor portion. Dr. B's office coder didn't agree with that. After discussion at their office, Dr. B is going to bill 61618, which is the actual repair of the leak.
    The portion of the surgery that Dr. A did was the approach (like a septoplasty (30520)but more extensive than that), but not as extensive as the codes in the section 61580-61591 for approaches. He said the closest code to what he did is the 61548 (but not the tumor excision part). We're trying to figure out what code to use for his portion. Any ideas???

    We have thought of 61548-52, but not sure that would be correct enough with just the modifier for reduced services.

    The operative report indicates the following as the procedure:

    1. Transseptal approach to the sphenoid sinus and cerebrospinal fluid leak. (Dr. A portion) 2. Repair of the spinal fluid leak and lumbar drain placement (Dr. B, the other surgeon)

    Thanks...any suggestions will be appreciated!

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default 62 modifier

    If the neurosurgeon feels that 61618 is the appropriate code to use, then both surgeons should use the same code with a -62 modifier on each of their codes.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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