Modifier 80 vs. 62

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Question:

I have a question concerning modifier 80. According to Medicare this modifier should be used when 2 different specialties are performing surgery on the same patient but not doing the same procedure. Modifier 62 can be used for 2 different specialties when performing the same procedure but also for the same specialty. Am I explaining this correctly?

Answer:

Modifier 80 is appended to the assistant surgeon’s codes, which are usually the same codes as the primary surgeon’s, when that surgeon is assisting the other. Typically the assistant is of the same specialty but sometimes other specialty physicians (e.g., general surgeon, family practice) may assist the primary surgeon. The primary surgeon is doing all the activities described by the CPT code(s) billed – the assistant surgeon is just helping out. The assistant surgeon does not dictate an operative report. Example: partner neurosurgeon assists on a discectomy (primary surgeon bills 63030, assistant bills 63030-80).

Modifier 62 represents co-surgery between two surgeons (Medicare says they must be of different specialties even though CPT does not) when the two surgeons share the activities described by a single CPT code. Two surgeons are necessary usually when neither surgeon performs the single CPT code on his/her own. Both surgeons dictate an operative report and both have pre and postop responsibilities. Example: ENT and neurosurgeon do a trans-sphenoidal/transnasal approach to excision of a pituitary tumor (both ENT and NS bill 61548-62).

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