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Co-surgery in Breast Reconstruction: Is the Helping Surgeon Actually Hurting?

Nicholas T Haddock1, Thomas C Troia2, Sumeet S Teotia1

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Plastic and Reconstructive Surgery. Global Open
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PubMed
Summary

The co-surgery model in microsurgical autologous breast reconstruction (MABR) improves efficiency but leads to financial underpayment and delayed reimbursement. Streamlining billing processes is crucial for wider adoption and improved patient outcomes.

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Area of Science:

  • Plastic Surgery
  • Surgical Oncology
  • Health Economics

Background:

  • Microsurgical autologous breast reconstruction (MABR) is resource-intensive.
  • The co-surgery model involves two experienced surgeons to potentially enhance outcomes.
  • This study assesses the financial and patient benefits of MABR co-surgery at an academic center.

Purpose of the Study:

  • To evaluate the financial implications of the co-surgery model in MABR.
  • To assess patient outcomes associated with MABR co-surgery.
  • To compare co-surgery versus single-surgeon models in MABR.

Main Methods:

  • Retrospective analysis of MABR procedures from 2021-2023.
  • Categorization of encounters into co-surgery (modifier -62) and single-surgeon groups.
  • Collection and statistical analysis of financial data (payments, reimbursement time) and patient outcomes (complications, flap compromise).

Main Results:

  • Co-surgery cases experienced significant underpayment ($86,748 over 3 years) and delayed payments compared to single-surgeon cases.
  • No significant differences in major patient complications like flap compromise or loss were observed.
  • Co-surgery cases showed higher rates of infection and breast wound complications, despite comparable operative times and lengths of stay.

Conclusions:

  • The co-surgery model in MABR offers efficiency gains but presents billing challenges, leading to financial losses.
  • Addressing reimbursement complexities is key to facilitating co-surgery adoption.
  • Optimizing the financial aspects of co-surgery can support its integration, potentially benefiting patient care and operational efficiency.