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Transphenoidal surgery

Jim Posted Fri 13th of January, 2012 23:26:59 PM

My ENT surgeon assisted an neurosurgeon with a transphenoidal resection of a macroadenoma. My surgeon performed the endoscopic approach to the tumor allowing access throught the spenoid sinus and then the neurosurgeon removed the tumor. How do I bill for my ENT's work. In one surgery my ENT performed a septoplasty , turbinate reduction and removal of a concha bullosa to allow access to the tumor. He removed the anterior sphenoid wall and removed the posterior 1/2 of the septum for the neurosurgeon. After the neurosurgeon was done my surgeon packed the sphenoid sinus and raised to nasoseptal flpas to close the defect.
Is this all included in assisting the neurosurgeon or how do I bill for these other procedures.

SuperCoder Answered Sun 15th of January, 2012 06:43:59 AM

Even though the term used in question is "assisted" but in this case, the ENT and neurosurgeon are working as cosurgeons (that is, the two surgeons are performing separate portions of the same surgery). Therefore, according to CMS and CPTguidelines, each surgeon should bill for the procedure with modifier -62 (Two surgeons) appended. You must support medical necessity for two surgeons in the accompanying documentation.
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A similar scenario is in one of our earlier publication. The details are in the link:
http://www.supercoder.com/articles/articles-alerts/nec/reader-question-documentation-and-modifiers-support-cosurgery/

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