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READER QUESTIONS:

Employ Modifier 55 for Post-Op-Only Care

Published on Tue May 19, 2009

Question: Because we are in a small, rural town, our physician sends many patients to a nearby city for surgical treatment and then sees them here in our office for post-op care so the patient does not need to travel back to the city for a short follow-up appointment. The physician says we should just consider these visits a patient courtesy, but I think there must be a way for us to bill for the post-op visits. What is the best way to handle this? Arkansas Subscriber Answer: If your office can work with the surgeons billing department, you can -- and should -- report the post-op visits your physician is providing Heres how: CPT codes are broken down into a preop/surgery/post-op split. This means, of the total allowable for the CPT code, a percentage is allocated for preoperative work, a percentage for the surgical portion, and another portion for postoperative work. [...]
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