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2 surgeons billing different CPT Codes

  1. Default 2 surgeons billing different CPT Codes
    Clearnace Sale
    When 2 surgeons are each performing a part of a procedure and they each bill a different CPT codes, is a modifier needed?

  2. #2
    Milwaukee WI
    Default Co Surgery
    Are you sure this isn't a co-surgery? Look at Appendix A in the CPT Professional Edition for modifier 62 Co Surgeons.

    Just because they are each performing a different part of the procedure, does not mean it is appropriate form them to code two different CPTs.

    I would have to see the operative report(s) to be sure, but I think you have a co-surgery situation - they should report the SAME CPT codes each with -62 modifier.

    If you truly have two distinct procedures (e.g. major trauma case, Doc A does the splenectomy; Doc B addresses the fractured hip), then each codes separately and no modifiers are required as co-surgeons.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  3. Default
    Is there any way to know when it is a co-surgeon and when itis not. When 2 sergeons are there each billing as a primary surgone-is it always a co surgeon situation? In this case the codes billed are on CMS list of Modifier 62 not allowed.

    The note from Dr A reads,
    Ureteral catheter placed by Dr B. Puncture of a dialated lower pole calix was performed by Dr A using a 18 gague trocar needle. >>>>>>>>>the Nephrolithotomy procedure was then performed by Dr. B. See Dr. B's dictation for details of that procedure.

    Dr. A billed 50080 and 52005
    Dr. B billed 50395 and 50392

    No modifiers were used, but I am not sure this is correct.

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