Wiki Charges during postoperative period

[sloseke]

One of the physicians at the Orthopedic office I work at is taking over the post-operative care for a patient who had an ORIF of a bimalleolar fracture done by an outside physician. My physician is questioning how the visits will be billed since the patient is in the post-operative period for this surgery.
Would we bill regular E/M services supported by the notes since we are in a different practice than the physician who performed the surgery?
Any input would be greatly appreciated.
Thanks!

 

[mitchellde]

You bill with the same ORIF code that the original provider used and append the 55 modifier using the V code for aftercare for healing fracture.

 

[sloseke]

Thank you for your help! I was also wondering, do you charge out the full price for the surgery and insurance then adjusts appropriately since the 55 modifier is appended?
What would the charge be if this were a private pay patient?
Thanks again for any input!

 

[CodingKing]

Let the insurance carrier take the reduction

 

[sxcoder1]

I thought in order to bill ORIF with modifier 55 that the surgeon who performed the surgery would also have had to bill the ORIF with a 54 and also have paperwork from the original surgeon stating they performed surgery only and are referring patient to another surgeon to take over care.