Wiki modifier 55

[chaveje]

Here is the senario.
Dr A did an apendectomy on this patient at hospital A and coded his surgery with modifier 54 ( surgical care only) then the patient was transfered to Hospital B because of a high risk issue and my provider Dr. B assumed the post-op care only (mod 55). Dr B provided services and admitted the patient to hospital B. My question is can my provider (Dr B) bill for the admission of this patient and the post op-care? Or is the admission part of the post-op care (mod 55).
Thank you

 

[gaponte]

Modifier -55

Is this Medicare? if so, modifier -56 does not apply. However, you can bill using modifier -55 along with inpatient follow-ups visits.

Medicare Claims Processing Manual:
"• If the transfer of care occurs immediately after surgery, the physician other than the surgeon who provides the in-hospital postoperative care bills using subsequent hospital care codes for the inpatient hospital care and the surgical code with the “-55â€� modifier for the post-discharge care. The surgeon bills the surgery code with the “-54â€� modifier."