Orthopedic Coding Alert

Question: We have taken over post operative care on a patient who had surgery from another physician. We want to be sure we are billing only the post-op care. Do we bill same codes as used by the first surgeon with modifier 55 (Postoperative Management Only) modifier?

New York Subscriber

Answer: The only time you can bill a surgical procedure with modifier 55 (Postoperative Management Only) is if the first clinician who performed the procedure billed his charges with modifier 54 (Surgical Care Only). Your follow-up care needs to be arranged with the original surgeon. Check if this has been done.