Urology Coding Alert

Question: I’m new to coding. When should I append modifier 62?

Wisconsin Subscriber

Answer: Modifier 62 (Two surgeons) applies to co-surgeons. To qualify for modifier 62, your physician must have worked together with another surgeon, and they both must be considered primary surgeons or co-surgeons. Once you have confirmed that your physician was indeed a primary co-surgeon, you must confirm that your physician worked together with the other surgeon to complete a procedure described by a single CPT^® procedure code. For Medicare, each surgeon must be of a separate/different specialty — such as a urologist and a general surgeon working together. For non-Medicare carriers, the co-surgeons may be of the same specialty, but often with different surgical expertise.

“When two 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 associate add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons,” according to CPT^®. “Each surgeon should report the co-surgery once using the same procedure code.”

Bottom line: Modifier 62 applies for only one primary procedure and its related add-on codes for each surgeon.