Co-surgery is eligible per procedure, not per operative session. This means that the performance of co-surgery at one procedure during an operative session for multiple procedures does not qualify all procedures performed during that session as co-surgery. Only those procedures in which the surgeon actually performs a portion of the procedure will be considered co-surgery.

The procedures on the Procedure Code Attachment are eligible co-surgery procedures when reported with the primary modifier 62 - two surgeons. The co-surgery allowance for these procedures is 62.5% of the contract allowance, per surgeon per procedure.  Multiple surgery guidelines are applied to these procedures. See Medical Policy Bulletin S-100 for multiple surgery guidelines.

Payment may not be made to the same surgeon for assistant surgery and co-surgery procedures performed during the same operative session. To review assistant surgery criteria, see Medical Policy Bulletin S-16.

Description

Co-surgery is a term that denotes two surgeons of different specialties performing, either simultaneously or at separate times, portions of one or more surgical procedures during the same operative session. Because co-surgeons are performing portions of a procedure, the same procedure code describes the services performed by both surgeons.

Co-surgery is not the same as team surgery, which is defined as two or more doctors, usually with different skills and of different specialties, working together to carry-out various procedures of a complicated surgery. Information on team surgery, can be found in Medical Policy Bulletin S-12.

NOTE:

This policy is designed to address medical guidelines that are appropriate for the majority of individuals with a particular disease, illness, or condition. Each person's unique clinical circumstances may warrant individual consideration, based on review of applicable medical records.

PRN References

06/1999, Co-surgery now eligible for payment
02/2000, Eligible co-surgery procedures change
02/2001, Additional co-surgery procedures now eligible
08/2001, Additional procedures eligible for co-surgery
12/2001, Additional procedures eligible for co-surgery
04/2004, Additional procedures eligible for co-surgery
10/2004, Additional procedures eligible for co-surgery
04/2005, Additional procedures eligible for co-surgery