tci Part B Insider - 2009 Issue 24

READER QUESTION: Prevent Co-Surgery Denials With Modifier Help

Remember: Co-surgeons can't share documentation. Question: Our physicians often work with other surgeons in the operating room. We seem to get a lot of denials for the procedures, however. I think we're using the wrong modifiers. What modifiers do we need to append to our claims to ensure payment on co-surgeries? Answer: If your physician is acting as a co-surgeon with another physician, you should report the procedure code and append modifier 62 (Two surgeons). For your modifier 62 claim to succeed, both physicians must submit claims for the same procedure, using the same procedure code, and both physicians...

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