Reimbursements

Category:

Co-Surgery

Reimbursement Policy: NDRP-Surg-002
Topic: Surgery
Effective Date: July 1, 2018
Last Reviewed:
February 22, 2019

Description:

This policy addresses reimbursement for eligible co-surgery procedures

Definitions:

Co-Surgery is defined as two or more surgeons, working together simultaneously as primary surgeons, to perform distinct parts of an operative procedure. Co-surgery is always performed during the same operative session.

Policy:

The Plan will reimburse co-surgery procedures at 62.5% of the contract allowance, per surgeon per procedure.  If there are multiple surgeries, the multiple surgery reductions will be applied.

Providers should append modifier 62 to codes that are being billed under this policy.

Cross Reference:

2018 National Physician Fee Schedule Relative Value File January Release

–  Co-Surgery – Code 2