Modifier 62
Modifier 62 will be added to claims for procedures designated as “co-surgeon allowed” when a claim for the same procedure code with modifier 62 has been previously submitted and processed for a different provider. Claims for more than one surgeon should have each surgeon’s provider identification number.
How would you use modifier 62?
Under certain circumstances, two surgeons (usually with different expertise) may be needed to perform a specific surgical procedure. An example of co-surgery is when one surgeon performs an incision and exposes the area requiring surgery and another surgeon performs the surgery.
What does the 62 modifier mean?
If two surgeons (each in a different specialty) are required to perform a specific procedure, each surgeon bills for the procedure with a CPT modifier 62 (two surgeons). Co-surgery also refers to surgical procedures involving two surgeons performing the parts of the procedure simultaneously, i.e., heart transplant.
How do you code a co surgeon?
In cases of co-surgery, each surgeon must append modifier 62 to services billed and the CPT code on both surgeon’s claims should match. Both surgeons are required to submit separate operative reports that explicitly state what services each surgeon performed during the surgery, reflecting the complexity of the case.
How does modifier 62 affect reimbursement?
Modifier 62 will be added to claims for procedures designated as “co-surgeon allowed” when a claim for the same procedure code with modifier 62 has been previously submitted and processed for a different provider. Claims for more than one surgeon should have each surgeon’s provider identification number.
When should modifier 62 be used?
Modifier 62 Two Surgeons: When 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work …
What is modifier 62 reimbursement?
Reminder: Modifier 62 indicates that the services of two or more surgeons were required for the same procedure(s), during the same operative session, on the same patient, on the same date of service.
Does Medicare accept modifier 62?
Medical Necessity Drives Use of Modifier 62 Medicare requires documentation that the procedure (or the patient’s condition) was of a nature that two surgeons of different specialties were medically necessary. This is identified in Medicare Physician Fee Schedule by an indicator next to the procedure code of 0, 1 or 2.
Does Medicare pay for co surgeon?
Medicare makes payment for co-surgeons when the procedure is authorized for co-surgeons and the person performing the service is a surgeon. Under some circumstances the skills of two surgeons (each in a different specialty) are required to perform surgery on the same patient during the same operative session.
When to use 62 modifier?
The 62 modifier is use when two physicians perform different parts of the same procedure. Such as spinal surgery, if the spine surgeon requires an anterior approach, he will have a surgeon from that surgical specially provide the opening and move the organs out of the way to expose the vertebrae.
What is modifier 62 mean?
Modifier 62. Two Surgeons. The individual skills of two or more surgeons are required to perform surgery on the same patient during the same operative session. This may be required because of the complex nature of the procedure(s) and/or the patient’s condition and the additional physician is not acting as an assistant at surgery.
What is the modifier for a co surgeon?
Modifier for co-surgeon. If he was a co surgeon then each surgeon performed different parts of the same surgical procedure so yes the codes will match and the modifier required by each surgeon is the 62. Each surgeons note will include that they took over at a point from the other surgeon or handed off at a point to the other surgeon.
What is the definition of 62 modifier?
Modifier 62. Coders use modifier 62 when two physicians work together on the same procedure. This modifier allows both physicians to bill for the same procedure code. Coders should not use this code if one physician served as an assistant for another physician.
