Wiki Post op care

[Betty Harris]

If a different provider other than the surgeon sees the patient for medical management, would you add modifier 55? Different diagnosis not related to the surgery.

 

[sls314]

If a different provider other than the surgeon sees the patient for medical management, would you add modifier 55? Different diagnosis not related to the surgery.

Modifier 55 is used when a different provider provides the postoperative care for a surgery. The provider who renders the postoperative care bills the surgical CPT with modifier 55. You can see this link from Noridian for additional information: https://med.noridianmedicare.com/web/jfb/topics/modifiers/55

Is there a reason you are looking for an additional modifier when the care is rendered by a different physician and is unrelated to the surgery? Are the physicians the same specialty and from the same practice?

 

[Betty Harris]

The hospitalist sees a surgical patient at the request of the surgeon for medical management. The surgeon does the post op for the surgery.

 

[csperoni]

The hospitalist should not need any modifier. Different specialty, different practice, and you are managing a problem, not providing postop care.