When you come face-to-face with multi-provider situation, the last thing you would want is to mess up your coding by assigning the wrong modifier(s).

Imagine a 70-year-old female patient presenting with COPD and coronary artery disease, status post myocardial infarction (CAD s/p MI) having a 28 mm of inner diameter thoracic aortic aneurysm. Imaging studies indicate the aneurysm to be descending. The cardiologist, together with a thoracic surgeon, decides to perform an open operative repair with graft replacement of the diseased segment.

The main key in a multi-provider scenario is to treat each physician’s work as a separate activity. However, deciding when to report a case as co-surgery, assistant surgery — or something else — has more to it than meets the eye. Find out what with this expert’s advice.

You know that a modifier is at hand in this case, but more importantly you should be able to tell what role each modifier plays in order for your procedure codes to blend well together. Here are the most common modifiers used in multi-provider situations:

• Modifier 62 (Two surgeons). Append this to each surgeon’s procedure when the physicians perform distinct, separate portions of the same procedure. Also referred to as co-surgery, modifier 62 applies when the skill of two surgeons (usually of different skills) is required in the management of a specific surgical procedure.
• Choose between modifier 80 (Assistant surgeon), modifier 81 (Minimum assistant surgeon), and modifier 82 (Assistant surgeon [when qualified resident surgeon not available]) when one surgeon assists the other with multiple portions of the case rather than completing his work independently. What to look for? Make sure your physician indicates in his documentation that he’s working with an assistant surgeon, what the assistant surgeon did, and why he or she was used during the case.
• Attach modifier AS

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