Forum - Questions & Answers

Mar 27th, 2014 - amtartaglione 2 

Two Surgeons working similanteously & switching sides to assist each other

My questions pertains to breast reconstruction w/free flap (19364) We are reviewing a surgical situation where 2 separate surgeons during the same surgical encounter are reconstructing a breast (Doc A on right, Doc B on left) throughout the separate procedures on each breast Doc A might switch to the left side then go back to the right side & Doc B would switch to the right side then go back to the left side.

Doc A is the primary surgeon for the left side

Doc B is the primary surgeon for the right side.

Can you please advise as to whether;

Each Doc should have a separate operative note dicatated for thier perspective primary procedure?

And

How should the specific documentation of the work they did to assist the other surgeon when they switched sides be indicated in the operative report?

And

Should the doctors documentation indicate the procedure they performed was a bilateral breast reconstruction, since technically, they state each doc was primary on only 1 breast & assisted on the other breast?

And

When each doc bills (each under thier own separate provider#) would the primary procedure 19364 (LT or RT) include modifier 62?

And
Would there be an additional line on the claim showing the secondary procedure as assisting the other doc on the other side 19364 (LT or RT) include modifier 80 or 82?

Thank you for any information you can supply.
Ann M. Tartaglione, CPC








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