Is It Co-surgery or Not?

September 15, 2016

I was asked by a urologist to clear a vena cava thrombus during his patient’s nephrectomy for a malignancy. I was able to dissect the malignancy from the vena cava without any reconstruction. I think I should bill for my work separately from the urologist. My coders disagree. How is this billed?

Thank you for your question. In the Society of Vascular Surgeons (SVS) Coding course we discuss numerous scenarios where more than one surgeon participates in a surgery. In your scenario, CPT code 50230 describes a nephrectomy, radical with regional lymphadenectomy and/or vena cava thrombectomy. In this case, two surgeons with different skill sets and specialties perform distinct parts of this single CPT code. This is classic co-surgery. You will report 50230 with a 62 modifier and the urologist will report 50230 with a 62 modifier.

Please join us in Chicago on October 21-22, 2016 for the SVS sponsored vascular coding course with KZA consultant Teri Romano as a faculty member. Can’t make the October course or have too large a staff for all to attend? Contact KZA for an intensive and interactive vascular coding course at your location.

*This response is based on the best information available as of 09/15/16.


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