# Co-Surgery



## abishard (Jan 19, 2010)

Co-surgery: 

Does anyone have anything in writing that states it is required for both co-surgeons to document their own operative note?


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## RebeccaWoodward* (Jan 19, 2010)

My carrier...

"Surgeons of the same or different specialty can use modifier -62, but unlike assistant surgeons, *each co-surgeon must dictate a separate operative report documenting his/her distinct operative work*. The operative report should indicate the medical necessity for having two surgeons act as co-surgeons."

http://www.cignagovernmentservices.com/partb/pubs/mb/2001/01_4/forall/b0104b40a.html


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## abishard (Jan 19, 2010)

Thank you Rebecca. If only my Medicare carrier (WPS) would state something like that.

I am trying to educate my surgeons on the difference between an assistant surgeon and a co-surgeon. 
CPT states, when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. 

Medicare Carriers Manual states an assistant at surgery serves as an additional pair of hands for the operating surgeon. He or she need not be a surgeon, or even a physician, and has no responsibilities other than the ones he assumes during the operation.

Any suggestions are appreciated.


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## RebeccaWoodward* (Jan 19, 2010)

Chapter 12? Section 40...

40.8=Co-surgery also refers to surgical procedures involving two surgeons performing the parts of the procedure simultaneously, i.e., heart transplant or bilateral knee replacements. Documentation of the medical necessity for two surgeons is required for certain services identified in the MFSDB.


http://www.cms.hhs.gov/manuals/downloads/clm104c12.pdf


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## FTessaBartels (Jan 19, 2010)

*We have WPS*

Amy,
I am in Wisconsin and we are covered by WPS Medicare.

In order to use the cosurgery modifier 62, we require that each surgeon dictate his/her own operative report outlining what s/he did and listing the other surgeon as co-surgeon. 

What kinds of scenarios are you talking about where you have co-surgeons (or maybe assistant surgeons)?

Typical cases for us are where the general or thoracic surgeon opens for the orthopaedic or neurosurgeon who is doing an anterior spinal fusion. Other cases involve neurosurgery and plastic surgery for infants requiring cranial vault remodeling. 

Hope that helps.

F Tessa Bartels, CPC, CEMC


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