Definition:
• If a team of surgeons (more than two surgeons of different specialties) is required to perform a specific procedure, each surgeon bills for the procedure with a modifier “-66.”
Appropriate Use:
• The MPFSDB identifies certain services submitted with a “-66” modifier, which must be sufficiently documented to establish that a team was medically necessary. All claims for team surgeons must contain sufficient information to allow pricing “by report.”
The folowing indicators identify services for which team surgeons may be paid:
0 = Team surgeons not permitted for this procedure.
1 = Team surgeons may be paid if supporting doumentation is supplied to establish medical necessity of a team. Paid by report.
2 = Team surgeons may be paid. Paid by report.
Facts
• Global surgery rules apply to each of the physicians participating in a team surgery.
• Reimbursement is determined “By Report.”
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