Question: The December issue of Gastroenterology Coding Alert featured an example of a PEG tube placement reported with modifier -62 (Two surgeons). Our office had no idea that modifier -62 could be used when coding for some PEG placements. What are some other procedures we may report with modifier -62, and what should coders keep in mind when considering the modifier? Answer: In a gastro office, coders would most likely use modifier -62 when coding for a PEG tube placement, which is reported with CPT code 43246 (Upper gastrointestinal endoscopy including esophagus, stomach, and either the duodenum and/or jejunum as appropriate; with directed placement of percutaneous gastrostomy tube). Because co-surgery claims are often the victims of intense scrutiny, each physician must diligently detail both the work he performed and the work the other physician performed. - Clinical and coding expertise for You Be the Coder and Reader Questions provided by Michael Weinstein, MD, a gastroenterologist in Washington, D.C., and former member of the CPT advisory panel; and Linda Parks, MA, CPC, CCP, coding and billing coordinator for GI Diagnostic Endoscopy Center in Marietta, Ga.
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There are other procedures that may call for a pair of surgeons, and thus modifier -62, but these are generally true surgical procedures and not endoscopic procedures. Some of these procedures include:
No matter which procedure you're reporting, make sure you answer these questions before using modifier -62:
Each physician should provide a note detailing what portion of the procedure he performed, how much work was involved, and how long the procedure took.
Both physicians must submit claims for the same procedure, and both physicians must use modifier -62 on their claims.
Good idea: If you want to go that extra mile with your modifier -62 claim, you should consider submitting a letter to the insurer explaining the reason for two surgeons.