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Orthopedic Coding Alert

READER QUESTIONS:

Use Modifier -80 Only for 2 Primary Surgeons

Question: If two surgeons work together during a procedure, should I apply modifier -62 or modifier -80?


California Subscriber


Answer: When deciding between modifiers -62 (Two surgeons) and -80 (Assistant surgeon), the most important question to ask yourself or the surgeon is, "Did both surgeons serve as a primary surgeon for at least a portion of the shared procedure?" If the answer is "yes," you should turn to modifier -62.

When acting as co-surgeons, the two surgeons operate on the same patient but, in fact, work independently of one another. In other words, each surgeon performs a distinct portion of a single reportable procedure.

Example: A general surgeon performs the surgical approach for an anterior lumbar fusion, after which the orthopedic surgeon performs the fusion. Each surgeon should report 22558-62 (Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare interspace [other than for decompression]; lumbar). Each physician should report the appropriate procedure code with modifier -62 appended

Alternative: You should use modifier -80 to describe the presence of a second physician in the operating room who acts as an extra pair of hands to assist the primary surgeon. For example, a neurosurgeon performs a decompressive procedure (for example, 63075, Diskectomy, anterior, with decompression of spinal cord and/or nerve root[s], including osteophytectomy; cervical,
single interspace).

Meanwhile, the orthopedic surgeon performs the graft harvest (such as 20938, Autograft for spine surgery only [includes harvesting the graft]; structural, bicortical or tricortical [through separate skin or fascial incision]), fusion (such as 22554, Arthrodesis, anterior interbody technique, including minimal diskectomy to prepare
interspace [other than for decompression]; cervical below C2) and plating (such as 22845, Anterior instrumentation; 2 to 3 vertebral segments).
 
The orthopedic surgeon may assist the neurosugeon with his portion of the procedure and vice versa. If your orthopedic surgeon assists the neurosurgeon with the decompression, you can also report 63075-80.
 
Important: Suppose two surgeons of different specialties each perform a distinct, separately identifiable procedure during the same operative session. You should consider this "sequential surgery," and each surgeon may bill independently, without appending any modifiers.


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