Results 1 to 5 of 5

66 vs no modifier

  1. #1
    Location
    Greater Pittsburgh
    Posts
    390
    Cool 66 vs no modifier
    Medical Coding Books
    Patient had spine surgery with 2 neurosurgeons from the same practice, but not my practice. They did: re-exploratory laminectomy L3-S1; interbody fusion L4-L5 and L5-S1; removal posterior instrumentation; pedicule instrumentation L3-S1; posterlateral fusion L4-S1.

    My Dr. Orthopaedic did sacral fixation and dictated separately.

    Plastic surgeon did gluteal flap coverage and closure and dictated separately.

    For my Dr.Ortho-sacral fixation.....do I need a 66 or no modifier.

    Thank you in advance for your assistance.
    Last edited by jdemar; 07-31-2009 at 11:15 AM.
    jdemar, CPC, CMA

  2. #2
    Default Looks like you need modifier 62
    Modifier 66 is when more than 2 surgeons (i.e., a "team") are billing for the same code (modifier 62 is for 2 surgeons). Since it looks like each of these providers performed a portion of the procedures listed, you will need to agree on codes and reimbursement split with the other provider, bill the same codes with modifier 62 appended to each code billed. Per 2008 Coder's Desk Reference (copyright Ingenix 2007), for modifier 62 it states, "...List multiple related procedures as though one physician performed all procedures and add modifier 62. The surgeons should agree on charges, procedure codes, and reimbursement percentage splits pror to submission. Because of many variables, it is imperative you coordinate the physicians' billing, and submit complete and detailed documentation."

    *********
    PB

  3. #3
    Location
    Greater Pittsburgh
    Posts
    390
    Default
    62 it is! Thank you for your help. I had only ever used 62 when my Dr. Ortho and Dr. Neuro did surgery together, and I guess the definition (two surgeons) threw me! Thanks again
    Last edited by jdemar; 08-05-2009 at 06:31 AM.
    jdemar, CPC, CMA

  4. #4
    Location
    Milwaukee WI
    Posts
    4,466
    Default Modifier 66
    I think in your scenario you ARE looking at modifier 66 ... you have 4 surgeons involved (2 neuro, 1 ortho, 1 plastics)

    All PB's comments re coordinating coding, billing, splits, etc and providing full documentation still apply.

    F Tessa Bartels, CPC, CEMC

  5. #5
    Location
    Greater Pittsburgh
    Posts
    390
    Default
    That's what I thought (66), because there were more than 2, ie(co surgeons 62).

    I understand and have always coordinated the CPT s and ICD-9-CM with other offices that were involved with co surgery.

    Thank you for your assistance. I am awaiting our reimbursement with the 66 modifier.
    Last edited by jdemar; 08-11-2009 at 02:49 PM.
    jdemar, CPC, CMA

Similar Threads

  1. Replies: 2
    Last Post: 09-18-2015, 02:17 PM
  2. Modifier 59 vs Modifier 91 for Laboratory
    By leahrey in forum Modifiers
    Replies: 1
    Last Post: 06-23-2015, 01:01 PM
  3. MODIFIER PT VS MODIFIER 33 Screening Colonoscopy
    By Ann Johnson in forum Modifiers
    Replies: 2
    Last Post: 07-19-2012, 08:08 AM
  4. Modifier 58 versus Modifier 78
    By Ramona03 in forum Medical Coding General Discussion
    Replies: 2
    Last Post: 06-04-2012, 01:10 PM
  5. Modifier 51 Versus Modifier 59
    By Sborkowski in forum Modifiers
    Replies: 3
    Last Post: 05-26-2009, 04:59 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?

Login

Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.