modifier 62

Modifier 62 | Two Surgeons Explained

Modifier 62 describes a situation where two surgeons work together as primary surgeons, each performing a distinct part of the procedure.

1. What is modifier 62?

Modifier 62 indicates that two surgeons worked as primary surgeons, each performing a distinct part of the procedure.

This modifier ensures that both surgeons are reimbursed for their work. When two providers work as primary surgeons, each performing part of a procedure, append modifier 62 to the same procedure code for each surgeon.

Each surgeon reports the same procedure code to the payer, appending modifier 62 to the code. Medicare reimburses each provider a percentage of the Medicare global surgery fee schedule amount for the procedure. Each provider must document the components of the surgery he performed.

2. When to use modifier 62?

Modifier 62 should be used when two surgeons work together as primary surgeons, each performing a distinct part of the procedure.

Examples of two providers working as primary surgeons for a procedure include complex conditions, such as a trauma patient in surgery for an extended time, which causes the surgeons to work in shifts to complete the procedure, and situations where each provider performs a component of the same procedure, such as a general surgeon preparing the surgical site, and a different surgeon performing the surgery.

Modifier 62 does not apply to team surgery or when surgeons of different specialties perform a different procedure during the same session for the same patient.

3. Description

The official description of modifier 62 is “two surgeons”.

4. Examples

Examples of procedures that require modifier 62 include:

  • A cardiac surgeon and a thoracic surgeon working together to perform a complex heart surgery
  • A general surgeon and a plastic surgeon working together to perform a breast reconstruction surgery
  • A neurosurgeon and an orthopedic surgeon working together to perform a spinal fusion surgery

5. Documentation

When using modifier 62, each surgeon must clearly document the components of their surgery. This documentation should include the specific tasks performed by each surgeon and the time each surgeon spent performing those tasks. This documentation is necessary to ensure that both surgeons are reimbursed for their work.

6. Billing

When billing for a procedure using modifier 62, each surgeon should report the same CPT code with modifier 62 appended to the code.

Medicare reimburses each provider a percentage of the Medicare global surgery fee schedule amount for the procedure.

7. Common mistakes

Common mistakes that medical coders make when using modifier 62 include:

  • Using modifier 62 for team surgery
  • Using modifier 62 when surgeons of different specialties each perform a different procedure during the same session for the same patient
  • Not providing clear documentation of each surgeon’s components of the surgery.

Medical coders should carefully review the documentation to avoid these mistakes and ensure that modifier 62 is only used in appropriate situations.

8. Other modifiers related to modifier 62

Other modifiers related to modifier 62 include modifier 80, Assistant Surgeon, or 82, Assistant Surgeon when a qualified resident surgeon is unavailable, which should be used when a co-surgeon assists another surgeon with a procedure but is not another primary surgeon. In addition, modifier 66 (surgical team) should also be used when a team of surgeons, typically three or more surgeons of different specialties, work together to perform a procedure.

9. Tips

When using modifier 62, medical coders should:

  • Ensure that both surgeons document the components of the surgery they performed
  • Verify that modifier 62 is only used in appropriate situations
  • Review the documentation carefully to avoid common mistakes

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