You Be the Coder:
Reserve 55 for Post-Op Package
Published on Mon Sep 27, 2010
Question: Would you please explain when we should use modifier 55? I am not clear on what "management" means. If another otolaryngologist, not the physician who performed the surgery, sees a post-op patient and admits him to the hospital during the 42-day global period, is modifier 55 appropriate?Alabama Subscriber Answer: You should use modifier 55 (Postoperative management only) when your otolaryngologist assumes all of a patient's postoperative care and there is a formal transfer of care from the surgeon. For instance, if a patient moves after surgery or returns to his local otolaryngologist for postoperative care after a distant otolaryngologist performs the surgery, you should claim the postoperative component with modifier 55.Nitty-gritty: Modifier 55 actually goes on the surgery code. Suppose a Chicago otolaryngologist performs a mastoidectomy (69501, Transmastoid antrotomy [simple mastoidectomy]) on a patient. The patient, who lives two hours away, chooses to see his local otolaryngologist for all [...]