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modifier question

  1. #1
    Question modifier question
    Medical Coding Books
    A new pt referred to us for post-op pain during the 90 day global. Do I bill the E/M code of 99203 with the modifier 55? Pt was sent to us by the surgeon to help manage the acute post-op pain.

    Thanks....

  2. #2
    Default modifier question
    You shouldn't use any modifier, your doctor did not do the surgery...you would only use the 55 mod if the surgeon has sent the pt to your doctor to do the post operative care (follow up care). The doctor who did the surgery is the only one that would need to use a mod if he did something else to the pt.

  3. #3
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    Quote Originally Posted by Thubler View Post
    A new pt referred to us for post-op pain during the 90 day global. Do I bill the E/M code of 99203 with the modifier 55? Pt was sent to us by the surgeon to help manage the acute post-op pain.

    Thanks....
    The 55 modifier is to be attached to the surgical procedure code and not E&M code. You might need to bill this way depending upon the payer.

    Debra A. Mitchell, MSPH, CPC-H

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