Two Orthopaedic Surgeons, Two Separate Surgeries

Question:

A patient sustained an ankle fracture and a shoulder fracture and surgery was performed on same day by two different surgeons (partners) during the same surgical session. Dr. “A” performed the ORIF of the shoulder fracture and Dr. “B” performed the ORIF of the ankle fracture.

Would they be considered co-surgeons?

Answer:

No, they are not co-surgeons.

Co-surgery is reported when two surgeons of different specialties are performing distinct, separate parts of surgical procedure defined by a single CPT code. The most common in Orthopaedics is in spine, where the vascular surgeon will do the approach to the anterior spine for an anterior spinal fusion and the orthopaedic surgeon will perform the fusion; the vascular surgeon may or may not return for the closure.

In your scenario both surgeons functioned independently doing their own surgical procedures. They will document their own surgical procedure and bill for the procedure they performed; they may mention that the other surgeon was simultaneously performing the other surgery but will not document anything about the other surgeon’s procedure.

You will not use any surgeon modifiers on either case. There is no overlap with the 2 surgical procedures so we would not expect the “XP” modifier be required. The XP modifier is defined as “Separate Practitioner, a service that is distinct because it was performed by a different practitioner” would be required. These procedures, by nature are separate and distinct.”