Ask Dr. Z

"Patient with left LE critical limb ischemia with gangrenous 2nd toe. Vascular surgeon A performs the upper extremity vein harvest of the cephalic and basilic veins while simultaneously vascular surgeon B performs fem-pop bypass with the spliced veins. Physician A documents the vein harvest procedure indicating that simultaneously Physician B has already started with arterial exposure of LE and then finalizes the procedure once the harvested veins are handed over by Physician A." Physician B also had an assistant (PA-C). Reason for both physicians is reduction of OR time and improved patient safety (documented by Physician A). Since each procedure is distinct and has its own CPT code, how would we capture this, as the vein harvest, performed exclusively by Physician A, is and add-on code and requires a base code which in this case was exclusively performed by Physician B? This scenario does not look to support a true co-surgery (based on 2 distinct procedures/codes and same physician specialty); however, is there a way to capture both physician services appropriately?