66 - JE Part B
Team Surgeons - Surgical Team
If a team of surgeons (more than 2 surgeons of different specialties) is required to perform a specific procedure, each surgeon bills for the procedure with a modifier 66. Sufficient documentation must establish that a team was medically necessary. All claims for team surgeons must contain sufficient information to allow pricing "by report."
This modifier states a single, highly complex surgery or procedure that requires several physicians from the same or different specialties.
- Includes other highly skilled and specially trained personnel
- Includes different types of complex equipment
- Usually confined to organ transplant teams
- Reimbursed "by report"
- Medicare Physician Fee Schedule (MPFS) Indicator List
- "T" column indicator 1 or 2
- Claim subject to Medical Review and documentation will be requested
- Every surgeon MUST append modifier 66 to the CPT code
- Not appropriate for two or less surgeons
Claim Coding Example
|Renal allotransplantation, implantation of graft; with recipient nephrectomy||50360 66|
Last Updated Tue, 25 Oct 2022 14:44:10 +0000