Modifier 62
Modifier 62 – Two surgeons
Some surgeries usually require two or more surgeons to perform the service. If two surgeons involved as primary surgeon to perform the service together, then each surgeon have to report the claim with his/her distinct operative work along with modifier 62 to indicate that two primary surgeons involved in performing the surgery.
Important Note: If co-surgeon acts as assistant surgeon for some of the additional procedures, other than those reported with modifier 62, during the same operative session, then that particular additional procedure codes should be reported with appropriate modifier 80 or 82.
Usage of Modifier 62 with examples:
- Cardiovascular System:
Below CPT codes are used to report Trans Catheter Aortic Valve Replacement (TAVR) & Trans Catheter Aortic Valve Implantation (TAVI).
33361
33362
33363
33364
33365
33366
To perform the above procedure that is TAVR/TAVI usually requires two surgeon operators and suppose if two surgeons involved as primary surgeons, then we need report the above components of the procedure by appending modifier 62.
Example:
Surgeon A should be reported with 33361 with modifier 62
Surgeon B should be reported with 33361 with modifier 62
- Renal Transplatation:
To perform the kidney transplantation, usually requires two or more surgeons to perform the service.
If suppose two surgeons by name Alex and Martin perform the kidney transplantation as primary surgeons, we should report the procedure code with modifier 62 to indicate two surgeons involved in performing the service.
Surgeon Alex should report his service with modifier 62 in same way Surgeon Martin has to report his service with modifier 62.
Example:
Assume two surgeons (Alex and Martin) performed renal autotransplatation and reimplantation of kidney as primary surgeons.
The above service is reported with procedure code 50380 by appending modifier 62 to indicate two surgeons involved in performing the service.
Surgeon Alex has to report the claim with procedure code 50380 and modifier 62
Surgeon Martin has to report the claim with procedure code 50380 and modifier 62.
- Bone Graft and Spinal Instrumentation codes cannot be appended with modifier 62
Assume arthrodesis performed by two primary surgeons, followed by bone graft and spinal instrumentation on the same operative session.
In this case each surgeon should report arthrodesis code with modifier 62. But the bone graft and spinal instrumentation should be reported by only one surgeon, who performed those procedures (Bone graft and spinal instrumentation) and should be reported without modifier 62 as per guidelines.
Example:
A patient with arthrodesis of L1-L3 underwent surgical repair. Surgeon A performed an anterior exposure of the spine and Surgeon B performed he anterior minimal discectomy to prepare interspace utilizing structural allograft.
For anterior approach of lumbar fusion we report with CPT 22558, each additional interspace we report with add on code 22585 and for utilizing allograft structural (Bone graft) we report with CPT code 20931.
- Surgeon A should be reported with following codes
22558 with modifier 62
22585 with modifier 62
- Surgeon B should be reported with following codes
22558 with modifier 62
22585 with modifier 62 20931