Wiki Modifier 55

[adankert16@gmail.com]

Hello,

I hope someone can help me, We have a patient that had a closed reduction to the wrist done by another provider that is not associated with us at a hospital just recent and is now coming to see us as a new patient for the same problem. Our physician is going to do the same procedure in the office, Do we need to use a 55 modifier on the fracture care?

 

[Orthocoderpgu]

If the initial provider did not use -54, and billed for the full 90 day global, that provider is going to get paid, not you. You can add the -55, but if the insurance has always paid the full value to the first doctor you are not going to get anything.

 

[adankert16@gmail.com]

This is the first time we came across this. Thank you for the help