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Urology Coding Alert

Put Patient -- Not Money -- First With Split Surgical Care

Published on Sun Jun 14, 2009

Plus, pay attention to whether your payer is recognizing your modifiers. You should never report services using modifiers 54 and 55 simply because of the practices financial benefit.Your urologist needs to document in the medical record, prior to surgery, the reason for providing shared care, as well as the patients request for, understanding of, and agreement to this care plan. The way these modifiers should be used is for the convenience of the patient, stresses Maggie Mac, CPC,CEMC, CHC, CMM, ICCE, manager at Pershing Yoakley & Associates, P.C. in Clearwater, Fla. Example: A patient wants to see a physician in New York for a surgery because of that physicians expertise in the particular surgery, but the patient lives in New Jersey. The patient does not want to travel to New York for the postoperative care. You would employ modifiers 54 and 55, she explains. It is decided, in advance, by [...]
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