Neurosurgery Coding Alert

Question: We have a neurosurgeon who performed a surgery on a patient and he is not part of our clinic but was on one of my surgeon's rounds on this patient. Can we bill it with a modifier 55 (Postoperative management only)?

Arizona Subscriber

Answer: Suppose, there are two surgeons, Dr. A from group 1 and Dr B from group 2. You work for group 2. Dr A is (on other days) delegating the postoperative care to Dr. B to round and follow up from the surgery date for the 90 days, In this case you can bill the surgical codes with modifier 55. However, if Dr. B is on call for Dr A (and Dr. A takes call for Dr. B) and he is only going to see patient while he is still confined to the hospital, during his call days but not for the full post-operative period, then you cannot bill for the postoperative period.