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Orthopedic Coding Alert

Reader Question:

New Guidance Will Help Anterior Fusion Claims

Question: Our surgeon worked as a co-surgeon during a level-C3 spine fusion performed using an anterior approach. Which modifiers apply to this type of surgery? Delaware Subscriber
Answer: Co-surgery for spinal procedures has caused some confusion recently due to differing carrier guidance, but the Medicare payer for Delaware, Maryland, Texas, Virginia and Washington, D.C., has tried to quell this problem by issuing a news brief about coding these services. According to a recent TrailBlazer release, -Effective Aug. 26, 2007, the instructions for billing co-surgery for an anterior approach to a spinal procedure are as follows: The procedure should be billed with the appropriate CPT code that describes the operative procedure. The same CPT code should be billed by both surgeons. The 62 modifier should be billed to indicate co-surgery. Submission of an operative report will expedite claim processing if the two-specialty requirement is not met.- Therefore, both surgeons would report the same code as one another, such as 22554-62, Arthrodesis, anterior interbody technique, including minimal discectomy to prepare interspace [other than for decompression]; cervical below C2), with modifier 62 (Two surgeons) appended.


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