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Thread: modifier 62 help!!!!!!!!!!

  1. #1

    Default modifier 62 help!!!!!!!!!!

    I have 2 of my doctors that decided to team up on a talus surgery. Does anyone know if both surgeons get the 62 or just one? Patient was morbidly obese so it took 2 surgeons to handle the case. Thanks!

  2. #2

    Default

    Yes, each surgeon should use the 62 if they were a team.

  3. #3
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    Default

    each surgeon must document their own note the first surgeon dictates which part he did and then at what point he hands over and the second surgeon dictates at what point he takes over to completion. Each surgeon bills the same CPT and each surgeon uses the 62. The reimbursement is 62.5% of the allowable. The 62 is for use when each surgeon is performing unique parts of the same surgery and it is common for anterior approach for spinal surgery. The procedure you are performing might not be allowable with a 62. If the surgeon needed an assist due to the obesity then you bill the assistant and the primary surgeon with a 22 modifier and use the 80 for the assist.

    Debra A. Mitchell, MSPH, CPC-H

  4. #4
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    Default Mod 62 for talus surgery?

    Debra Mitchell's advice above is good. To that I would add:
    1. When considering modifier 62 on any surgery the first thing to do is look up that particular code and see if it is billable with modifier 62. Not all surgery codes are. If is is indeed a co-surgery, then both docs report the same code and both append modifier 62. If only one submits the 62 and the other does not, someone is not going to get paid.
    2. If it isbillable with modifier 62, then determine if each surgeon is performing a distinct part of the same procedure, rather than Dr. B simply assisting Dr. A due to the difficulty of the case.
    3. If yes, then determine that each physician has dictated his own operative report describing his unique part of the shared CPT code, and named the other surgeon as co-surgeon on their respective reports. If this was not done, you can't report it as such.

    You did not provide the CPT code(s) for this particular case (always helpful), but from the info you provided, it doesn't really sound like a co-surgery to me, and would be billed as Debra M.'s advice in her last sentence.
    Last edited by specialtycoder; 04-28-2012 at 01:14 PM. Reason: additional information

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