May 28, 2020
Hello! I have a plastic surgery question. I perform DIEP surgeries and when I do a bilateral DIEP I have a colleague scrub with me, and one of us will do the belly dissection while another does the chest dissection. We are both plastic surgeons. At my previous institution we were able to bill with a 62 modifier as it is a complex surgery and to facilitate minimizing the amount of time that a patient is under general anesthesia. My current billers in my new institution are saying that because we are both plastic surgeons we cannot bill with a code 62 modifier? Please help!!
Good question. Using modifier 62 for two surgeons of the same specialty is payor dependent. For example, Medicare will reimburse modifier 62 when the two surgeons are of different specialties (e.g., ENT and Plastic Surgery) – Medicare will not reimburse modifier 62 when the surgeons are of the same specialty (e.g., plastic surgery). Payors consider Plastic Surgeons to be of the same/single specialty and do not recognize subspecialty or fellowship training.
*This response is based on the best information available as of 05/28/20.