Modifier 62, two surgeons
When two surgeons work together as primary surgeons performing distinct parts of a procedure, each surgeon should report the co-surgery once using the same procedure code and report his/her distinct operative work by adding modifier 62 and any associated add-on code(s) for that procedure.
Per the AMA CPT rules for modifier 62, two surgeons may only be co-surgeons on one primary procedure and any associated add-on codes or additional procedures if the two surgeons continue to act as co-surgeons performing distinct separate parts of the same procedure.
- If additional procedure(s), including add-on procedures, are performed during the same surgical session, separate codes may also be reported with modifier 62 added.
- Per the AMA rules, you cannot append modifier 62 to the instrumentation or grafting codes.
- If a co-surgeon acts as an assistant in performing additional procedure(s) during the same surgical session, those services may be reported using separate procedure code(s) with the modifier 80 or modifier 82 added.
- Do not report an 80 modifier with a 62 modifier when two surgeons are working together on co-surgery. It is implied within the description of the 62 modifier that each surgeon will be "assisting" with the procedure.
- Report both the 62 modifier and the 50 modifier (bilateral procedure) when co-surgery is done by surgeons of the same specialty.
- Append the 62 modifier to add–on codes the same way you would with any other co-surgery service.
- Communicate with the staff of the other surgeon billing co-surgery so claims are submitted in the same time frame.
Documentation requirements for modifier 62
Additional reimbursement will be considered only when the documentation submitted clearly states the medical necessity of the co-surgery.
- Each surgeon must document the separate procedures they are performing, or portions of procedures in individual op reports.
- If multiple procedures are performed not all will necessarily meet the standard for co-surgery.
- Billing must include the supporting documentation for use of modifier 62 versus modifier 80.
- AI modifier
- Anatomic modifiers
- Anesthesia modifiers
- AT: Active treatment
- GA and GY: Medicare non-coverage notification
- GN, GO & GP: Therapy type
- UD and UA: Treated and released or admitted/transferred (Medicaid only)
- XE, XS, XP, XU: Distinct services
- 22: Unusual procedural services
- 25: Significant service separate from E&M service
- 26 and TC: Professional and technical components
- 33: Preventive service
- 50 & 51: Bilateral and multiple procedures
- 52: Reduced services
- 53: Discontinued procedure
- 54 & 55: Surgical care and post-op care
- 56: Pre-operative management only
- 57: E&M service same day or before major surgery
- 59: Distinct procedural service
- 62: Two surgeons
- 73 & 74: Discontinued outpatient surgery
- 76 & 77: Repeated procedures, same day
- 78: Unplanned return to operating room
- 80, 81, 82: Assistant at surgery