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Wiki Help Modifier 55

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mray906

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Monroeville, PA
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Has anyone has any experience using a 55 modifier?

Our scenario is we saw a patient that had an ORIF of her ankle by another surgeon not affiliated with our practice. That surgeon doesn't except her insurance and referred her to us for post op care.

I am not clear on how we bill the visit with a 55 modifier. What I am reading states to bill the exact surgical procedure code on the first date of service with the 55 modifier but I don't know if I am interpreting that correctly
 
yes that is correct, do not use an E&M code at all. Also in box 19 include your transfer of cae note to show that the surgeon transferred the patient to you.
 
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