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General Surgery Coding Alert

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Untangle Assistant Surgeon Puzzle

Question: I'd appreciate some help with how to bill for the following scenario for a patient with a vena cava thrombus during a kidney removal:Physician A and an assistant physician B, both in the same group, performed an open radical nephrectomy without taking regional lymph nodes. A vascular surgeon was called in to help with the evacuation of vena cava thrombus, which he performed with the assistance of physician A. Because the vascular surgeon is new to this area and is not credentialed, he will not be billing for his portion of the procedure. Tennessee SubscriberAnswer: You should bill 50230 (Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy) for physician A and 50230-80 (Assistant surgeon) for physician B. Notice that this code describes nephrectomy with regional lymphadenectomy and/or vena caval thrombectomy, so the fact that lymph nodes were not taken [...]