Wiki Teaching hospital - info on rules

[cynthiabrown]

Need black and white info on rules for mod 80 81 82 62 for teaching hospital. Docs are in same group.thanks

 

[FTessaBartels]

Teaching Hospital Assist

In a teaching hospital you would use modifier 82 when one surgeon assists another - in the absence of a qualified resident. The primary surgeon will dictate the operative note and must state in the note the fact that no qualified resident was available, so another surgeon was required for assist.

Modifier 62 is for co-surgeons. There is no difference in a teaching hospital in the application of co-surgery coding. Each surgeon dictates his/her own operative note, and lists the other surgeon as the co-surgeon. Both use the same codes with the -62 modifier appended to both claims. (Reimbursement is typically 62.5% of the allowable for EACH surgeon.)

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[cynthiabrown]

thanks Tessa, that is what i thought! we seem to have a problem getting reimbursement
on 62 modifier....any tips?

 

[FTessaBartels]

A couple of things re -62 modifier

First - be sure that the code(s) you are using accept the co-surgeon modifier.
Second - the two co-surgeons must use the exact same codes, and BOTH must use the -62 modifier.
Third - you will virtually always have to submit the operative notes - BOTH of them - to show that this is not a duplicate billing.

Hope that helps.

F Tessa Bartels, CPC, CEMC