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Jennifer Posted Thu 19th of October, 2017 08:20:49 AM
If the provider needs to explore the neck for vessel for anastomoses after another provider did the neck dissection, is that billable? (bill 35761 with 15757)
SuperCoder Answered Fri 20th of October, 2017 07:22:08 AM

Hi,

Exploration of neck will be billed using CPT code 35761 with an appropriate modifier. According to CMS guidelines, the work of surgeon, individually performed on the same patient and same session, both will be reimbursed using different modifier.

Similarly, CPT code 15757 will be billed using modifier. In this scenario, 62 modifier will be billed according to the service performed by the surgeon.

When 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. Each surgeon should report the co-surgery once using the same procedure code. If additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. 

Hope this helps!

Jennifer Posted Thu 26th of October, 2017 13:00:35 PM
Can the same physician who is performing 15757 bill for the 35761 prior to his microvascular anastomosis? Or is that considered the "prep work" to 15757?
SuperCoder Answered Fri 27th of October, 2017 03:23:02 AM

Hi Jennifer,

Same physician who is performing 15757 can bill for the 35761. When 15757 is performed with another separately identifiable procedure, the highest dollar value code is listed as the primary procedure and subsequent procedures are appended with modifier 51. 

Hope this helps!

 

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