Co-surgeon 2 specialty requirement

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pedscoder
Posts: 23
Joined: Wed Jun 03, 2015 10:18 am

Fri Sep 14, 2018 9:49 am

Hi,

Is it only Medicare that requires the 2-specialty requirement for billing co surgeries? "Co-surgery refers to a single surgical procedure which requires the skill of two surgeons, each in a different specialty, performing parts of the same procedure simultaneously."

The modifier definition itself does not indicate different specialties, so I wonder if commercial payors would allow use of mod 62 for same-specialty surgeons? Any guidance is helpful, thank you!
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admin
Site Admin
Posts: 431
Joined: Mon Apr 09, 2012 1:54 pm

Mon Oct 08, 2018 8:08 am

Good morning,

It is possible some payers will not follow the guidance from CMS, but my experience with the major ones is they do. You will have to search your individual payer policies to know for sure. This may be as simple as a quick google search. For example, I googled BCBS co surgeon and the first hit was from BCBS of NC. They do follow the CMS policy.

https://www.bluecrossnc.com/sites/defau ... elines.pdf

Your question has been answered by Pam Vanderbilt, CPC, CPMA, CPPM, CPC-I, CEMC, CEMA
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