Neurosurgery Coding Alert

Question: Do sequential procedures qualify for co-surgery? Two of our neurosurgeons did a staged procedure on the same patient. Can we submit the procedure codes with modifier 62 for co-surgery?

Georgia Subscriber

Answer: Sequential procedures do not qualify for co-surgery and you cannot append modifier 62 (Two surgeons) to the procedure codes. In the description shared, the two surgeons belong to the same specialty but seem to have performed different procedures in the same patient at different points in time. The surgery may be a staged procedure but the same procedure codes may not apply to the two stages. Hence, each of the surgeons can submit the appropriate procedure codes and these should be paid 100 percent.

For two surgeons to qualify for co-surgeons, you should be able to identify the following parameters:

1. Both surgeons perform different components of the same procedure and both will submit the same procedure code.
2. The surgeons may be from same or different specialties.
3. The surgeons may or may not simultaneously perform parts of the single procedure.
4. The two surgeons identify each other as co-surgeons and submit independent documentation of the work done by them during the procedure.
5. If the surgeons perform any additional procedures as co-surgeons during the same surgical session, reported with associated add-on codes, the two surgeons can also submit the add-on codes with modifier 62.

Remember that CMS requires documentation of medical necessity for some procedures when reporting the modifier 62 for co-surgery.