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.

This medical policy may not apply to FEP.  Medical policy is not an authorization, certification, explanation of benefits or a contract.  Benefits are determined by the Federal Employee Program.

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
10/2005, Additional procedures eligible for co-surgery
10/2006, Additional procedures eligible for co-surgery