This is a really good slide, too. It’s titled 33206-33208.
Alicia: Yeah, pacemakers.
Q: A cardiologist implants a new pacemaker (doesn’t matter how many leads) and has a general surgeon create the pocket, puncture the vein for the leads, and close the pocket. The cardiologist does all the rest of the work. Would you bill the initial insertion of everything – code and then the range.
A: And I don’t think she meant to say -52 because that’s Reduced Services, but I think she meant to say -62 because it is saying -62 on something else. Let’s go look. It isn’t a reduced service I can tell you that right now; however, it does get the topic a bit confusing. I was able to find some really good information to just spell it out for you, that I think will alleviate the confusion.
So, there’s the question, and again it is -62. That they saw this on LinkedIn for the AAPC forum and there are the two surgeons (modifier – 62) or an assistant surgeon (modifier – 80). She said “I have never coded cardiology. Not understanding the procedure well enough. It almost sounds like the general surgeon performed most of the procedure?”
Well, it would sound like that, and she’s right. Ignorance, I always say “Ignorance is a lack of knowledge.” So, I’m not saying you’re ignorant but you do have a lack of knowledge of this and doing the modifiers will help you out. It doesn’t matter which one has more or less.
My computer is telling me it’s trying to connect, so if I get knocked off Laureen gets the takeover. Yehey! I’m glad you got back.
Laureen: I can still see it.
Alicia: Good, OK. So, let’s just go ahead skip down. And again, I think she meant this to be a 62. So, I’m going ahead and just change that to a -62.
Laureen: No, I think she’s saying -52. She’s very confused, so…
Alicia: OK. So, we’re just going to spell it out. The answer is, it’s going to be modifier -62 and that is for Co-Surgeons. As long as the codes accept the two physicians and not an assistant, so co-surgeon is when you have two surgeons and they’re usually because – which Tammy gave me this information when they’re doing pacemakers, she said it’s usually because the patient is not in really in good health. And then she brought up a point I didn’t know but they’ll do this with… it’s not general anesthesia, they’re somewhat awake so they can talk to him and ask him “Are you feeling OK? Are you lightheaded…?” which amazed me.
Cardiologists Medical Coding 33206 – 33208 – Video
Let’s define what the definition is for Two Surgeons, modifier -62. So, you have two separate surgeons and they are performing two distinctly different aspects of this procedure, alright? So, by adding the modifier -62, you have… And let’s see for that procedure as long as both surgeons continue to work together as primary surgeons. So, each surgeon should report the co-surgery once using the same procedure code. Let’s see if additional procedures including add-on procedures are performed during the same surgical session, the separate codes may also be reported with -62.
So, here we go, they’re going to tell you, now note this: if a co-surgeon acts as an assistant in the performance of additional procedure(s) or other than those reported with the modifier-62, during the same surgical session, those services are going to be reported with modifier -80 or -82, an appropriate. So, you’ve got surgeon 1 and 80 is assistant surgeon. That means, you have one primary surgeon and the secondary surgeon is just assisting the first surgeon. He’s not doing a separate procedure.
I just grabbed 33206 – Insertion of new or replacement of permanent pacemaker with transvenous electrode(s); atrial.
We got our two surgeons A and B, let’s say surgeon 1 is going to insert the pacemaker; surgeon 2 is going to make the pocket that the pacemaker goes in and they’re also going to close up the pocket. He’s going to create the pocket, this surgeon is going to run the leads down through the veins and into the heart and test it and everything, and this one surgeon is going to close this pocket up.
Both surgeons are going to write an Op report for the same code. They’re going to append that -62. This surgeon is going to say nothing about the surgeon over here or will distinctly say that surgeon B did X, Y, and Z, but this Op report is for me. He’s going to sign it and it’s separate, “I inserted the pacemaker.” He