Medicare Compliance & Reimbursement

Coordinate surgeon claims or chance missed reimbursement. When coding surgical claims, pay special attention to whether a second surgeon works with your surgeon to provide the approach and closure portions of the procedure. If so, you'll have to take some additional steps to gain fair payment. Look to Modifier 62 for Co-Surgeons When two surgeons work together to perform distinct portions of a procedure CPT identifies with a single reportable code, you'll need to access modifier 62 (Two surgeons). For example, suppose a neurosurgeon is performing an anterior approach arthrodesis, and requests that a general surgeon exposes the surgical area and closes the patient following the procedure. The neurosurgeon performs the arthrodesis, along with related bone graft and instrumentation procedures. "When a general surgeon does the exposure for a spine case, modifier 62 is used," says Myra P. Anderson, CPC, CCAT, CPAT, coding educator with Ochsner Health System. "Both surgeons [...]