Wiki Co-Surgeon Billing


Spartanburg, SC
Best answers
I have a spine physician who uses another physician to help "open" the patient when completing an anterior spine surgery. I have been billing the fusion portion with a 62 modifier, but my physician is stating he doesn't feel like the other physician shouldn't get this charge since he is only there to help "open" the patient. Do any of you bill in this same situation? How do you bill?
The General Surgeon (usually) who makes the Incision, does the Tissue Dissection, which results in the Exposure of the Spine for the Spine Surgeon certainly deserves to bill and charge for his part of the procedure. Modifier 62, as I read it "implies" that both surgeons remain in place for the duration of the procedure, and work together as "Co-surgeons." What is happening in reality for your case is that they are working in "tandem," which doesn't seem to fit with 62. You might consider Modifier 66: Surgical Team instead, as it appears to me to cover the "concept" of Tandem Surgeons better.

Respectfully submitted, Alan Pechacek, M.D.
Our Spine Surgeon uses another Surgeon when he is performing the 360. The other Surgeon is performing the Anterior Approach in order for our Surgeon to get to the spine to do his part. We bill with the -62 and they both dictate what their distinct part of the procedure was performed. As long as the documentation explains what each Surgeon is doing you will be paid.

A Surgical Team is more than 2 physicians working together on complex surgeries and this would not qualify for the -66.

Hope this helps.