Wiki Two surgeons

[KimPhillips]

I have a physician that worked with another physician in the OR but I am unsure on how to bill. The codes are 21365 and 21406. Do both physicians bill with modifier 62? How does the insurance pay each physician? Any help would be appreciated.

 

[NikhilCPC]

first Billed higher dollar value claim first & without modifier and append modifier 62 with second procedure which has less dollar value then first one. so according to insurance they will pay for both procedures As per their fee-schedule. the payment must be in full as per their fee-schedule because payment reduces in case of Assistant surgeon.



Hope it helps

Regards,
Nikhil

 

[vpcats]

These are not the same procedure codes. Each surgeon reports his/her own code separately.