Co-surgeon: CABG procurement of vein

[Sharon Clarke]

When coding 35510-35516 there is a directive to use Modifier 80 on these codes if a co-surgeon perform the procurement of the vein.

How would we code the work for the co-surgeon, since procurement of vein 35500 (upper extremity) and 35572 (femoropopliteal) are add on codes, not stand alone codes?

 

[Laureen]

Hi Sharon - The assistant-surgeon (not co-surgeon) is reporting the same primary procedure as the primary surgeon - they just append a -80 to their codes to indicate they were the assistant and get the fee reduced accordingly.

The guideline states "When a surgical assistant performs graft procurement, add modifier 80 to 33510-33516." Those are the CABG procedures themselves which include vessel procurement (with some exceptions). What was happening was instead of the assistant reporting a -80 on the main procedure they were trying to report the procurement code separately (more money) which they can't do b/c it is bundled into the CABG procedure. That's what this guideline is reminding the of.

If the vessel procurement was for one of the exceptions i.e.. upper extremity vein or fempop vein they they would report the add-on codes for that in addition to the primary CABG code. Again the assistant would append modifier 80 to all procedures reported by the primary.

HTH

 

[Sharon Clarke]

Thank you! Seems so simple when stated this way. I had incorrectly thought it was the principle surgeon who utilised modifier 80. This makes more sense. Now, would the principle surgeon require a modifier as well to indicate they did not complete all phases if the procedure?

Many thanks!

 

[Laureen]

No the principle surgeon does not modifier 80. They may use modifiers like 51 etc. and the assistant surgeon would then copy that but they start with modifier 80 to indicate they were the assistant.

 

[Sharon Clarke]

Perfect! Thanks!