Office of Inspector General Releases Active Work Plan to include Medicare Part B payments to Physicians for Co-Surgery Procedures
The Office of Inspector General (OIG) has published recently added work plan items to include Medicare Part B payments to physicians for co-surgery procedures. According to CPT®, “When 2 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 associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. Each surgeon should report the co-surgery once using the same procedure code. If additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added.“ By appending modifier -62 to the CPT® procedure code(s), the fee schedule amount applicable to the payment for each co-surgeon is 62.5 percent of the global surgery fee schedule amount.
The objective of the OIG was to ensure Medicare Part B payments to physicians for co-surgery procedures were properly made by auditing a sample of claim line items in which different physicians billed for the same co-surgery procedure code(s) for the same Medicare beneficiary on the same date of service. To review the OIG’s Work Plan, including background, objectives and updates, click the following link:
