Wiki Co-managed patients

[rogers]

I am new to ophthamology billing and I am hoping someone can help me understand how to correctly bill Co-Managed patients when cataract surgeries have been performed using the 55 modifier. If the surgery took place on 8/19 and the patient was released to the co-managing physician on 8/25 how do I correctly bill this patient for my surgeon if he sees this patient one last time on 8/25 and releases him at that time to Dr. X who is also co-managing? Thanks in advance for any help!

 

[mrsjehu]

You will bill the cataract surgery with the -55 modifier. The co-managing Dr. will then bill the after care with a -54 modifier.

 

[rogers]

Thank you for the reply How many units do I bill the service with?

 

[mrsjehu]

For the surgery you bill one unit with the correct eye modifier.

 

[rogers]

Thanks so much!

 

[stevegadsby]

The surgeon should bill with the -54, the co-managing doctor doing the post-op care should bill with the -55 modifier.