Janice Posted Thu 24th of August, 2017 16:14:41 PM
i am getting a rejection for 33361 62 modifier should i be billing this
there was to different surgeons
SuperCoder Answered Fri 25th of August, 2017 06:01:02 AM
Modifier -62 (co-surgeons) must be appended to codes 33361 – 33365 (payment will be denied if submitted without the -62 modifier)
When submitting claims with modifier 62, each physician must document his or her own operative notes, detailing what portion of the procedure he or she performed, how much work was involved, how long the procedure took, etc. Each physician should identify the other as a co-surgeon; both surgeons should link the same diagnosis to the common procedure code; and each will submit his or her own claim.
Medicare and many other payers pay for codes appropriately submitted with modifier 62 at 125 percent of the usual fee schedule amount. The payer divides this between the two surgeons reporting the procedure, so each surgeon receives 62.5 percent of the regular fee.
NOTE: If the operating surgeons fail to coordinate their claims, however, one or both surgeons may not receive the earned reimbursement. For instance, if surgeon A sends his claim without a modifier appended, and his claim is the first to reach the payer, surgeon B (who acted as a co-surgeon) may have his or her claim rejected as a duplicate.