Gastroenterology Coding Alert

When two surgeons work together to perform one procedure, each physician's individual documentation requirements can get jumbled.

Make sure your gastroenterologist isn't passing the documentation buck and that he or she knows to follow these four guidelines when you are submitting claims with modifier -62 (Two surgeons).

1. Each physician should document her own operative notes. When surgeons are acting as "cosurgeons" it is implied that they are each performing a distinct part of the procedure which means they can't "share" the same documentation, says Linda Parks, MA, CPC, CCP, coding specialist for GI Diagnostics Endoscopy Center in Marietta, Ga. Each physician should provide a note detailing what portion of the procedure she performed, how much work was involved, and how long the procedure took. Including a brief explanation for the need for cosurgeons will help to avoid denials and reimbursement delays.

2. Each physician should identify the other as a co-surgeon. It is not enough for just one surgeon to indicate the other as his cosurgeon. It is imperative that both physicians are submitting claims for the same procedure, both with modifier -62.

3. Each physician should link the same diagnosis code to the common procedure code. Though this requirement may seem obvious, if two physicians are serving as cosurgeons to perform one procedure, the diagnosis code(s) they link to the CPT code should be the same and it almost always will be, Parks says. Before submitting a claim with modifier -62, someone in the practice must confirm that both claims have the same ICD-9 code(s).

4. Each physician should submit his own claim with his own documentation. Because claims for co-surgeons of the same specialty can come under scrutiny, it is imperative that each physician diligently detail both the work he performed and the work the other physician performed. Many physicians even submit a letter to the carrier detailing the reason for two surgeons. Because so much coordination of claims goes on with modifier -62, get a game plan together outlining what each surgeon is going to do to complete the procedure and how they are both going to document and code for it this is one surefire way to improve your chances of getting the reimbursement you deserve on the first try.