|
36.4.47.7 Cosurgery
Cosurgery (two surgeons) is reimbursed when the skills of two surgeons (usually with different skills) are required in the management of a specific surgical procedure. Cosurgery is for a surgery where the two surgeons' separate contributions to the successful outcome of the procedure are considered to be of equal importance. Prior authorization is no longer required, nor will it be issued for cosurgery.
Note: No additional reimbursement will be made for an assistant surgeon.
When billing for services provided during a cosurgery, each surgeon (usually of different specialties) must bill using the same CPT code(s), along with CPT modifier 62. Each surgeon is reimbursed 58 percent of the highest paying procedure and 29 percent of each secondary procedure. No cosurgery payment is made for claims submitted without CPT modifier 62. In instances where the surgeons do not use CPT modifier 62, the first claim received at TMHP for the service is considered that of the primary surgeon, and the subsequent claim is denied as a previously paid service.
|
