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Old 10-20-2010, 10:19 AM
medicalsec medicalsec is offline
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Default Re: Assist or Cosurgeons Cpt 15734

If a general surgeon and a plastic surgeon worth together to repair a ventral hernia and it involves a bilateral muscle flap (Cpt 15734 x 2 units) and Cpt 49565 and 49568 shouldn't they either be cosurgeons or one bill as the assistant. The plastic surgeon wants to bill for the flap and have the surgeon bill for the hernia. It would seem to me that this would unbundle the procedure because they are both working together to repair one problem which is the hernia.

Any thoughts?


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Old 10-20-2010, 05:47 PM
FTessaBartels FTessaBartels is offline
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Default Sounds like co-surgery

Can't tell for sure without the operative notes ... BUT ...

Sounds like a co-surgery scenario to me. Both surgeons bill the same codes with the -62 modifier. Each should be reimbursed at 62.5% of allowable.

BOTH must dictate their operative notes; each one describing what s/he did in the case.

Hope that helps.

F Tessa Bartels, CPC, CEMC
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