Co-surgeon's op report documentation modifier 62


Escondido, CA
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I need to find documentation to back this up to provide to a co-worker as I can't find back up on the internet or CMS.

I have a co-surgery case where there are two procedures being done. Dr. W dictates her op report for the colectomy & states at the end of her report that Dr. S will dictate the portion of hepatectomy & vice versa.

The Payment Policy Indicator is 1 on both of these procedures therefore each report needs to state why another surgeon was needed (medical necessity) on each other's procedure.
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In order to meet the definition of the 62 mod, two surgeons, of different specialties, have to be performing ONE procedure (and you have to have documentation to support the need for two surgeons to work on that single procedure). You'd then have to bill the same procedure code + -62 for each provider separately. As silly as it sounds, I look at it as a teeter-totter; two people have to be on the teeter-totter to make it work.

For arguments sake, let's say procedures XXXXX and YYYYY were done. If you have two separate procedures, in order to bill for co-surgeons, both Dr. W and Dr. S have to both participate "equally" (for lack of a better word) on both procedure XXXXX and YYYYY. Subsequently, both Dr. W and Dr. S MUST document both procedures and what they did for procedure XXXXX and YYYYY. If Dr. W only dictates the details on procedure XXXXX and Dr. S only dictates the details on procedure YYYYY, then it would appear as those they did not participate in both. So, Dr. W must dictate that she did such and such for XXXXX and such and such for YYYYY. Dr. S would have to document the same way. (Aside from the fact they'd BOTH need to include the reason why two surgeons were there). Simply documenting "I did such and such for procedure XXXXX... and Dr. S will dictate procedure YYYYY" will not cut it. That would most likely be interpreted to be Dr. W did procedure XXXXX and Dr. S did procedure YYYYY, hence they would not be co-surgeons.

It may be the same session, but if Dr. W sat on the teeter-totter alone and then Dr. S sat on the teeter-totter alone, that's not a co-surgeon situation.

This MIGHT help: