Wiki co managing patient care

[lconley]

I thought the ruling on this changed recently but I cannot find anything. Can my doctor do surgery on a patient and then refer them back to the referring physician for the post operative care? It use to be considered fee splitting, but I beleive the ruling changed. I really need some input on this.

 

[dkeown]

Well, as I understand it, the referring physician sees the patient and refers them to your doctor for the surgery, appending modifiers -56 and -55 to their visits. Your doctor then performs the surgery and appends modifier -54 to their billing claims and returns the patient to the referring for follow-up care. All of this is insurance carrier dependent, so check with them to see how they want it reported.

Hope this helps!

David Keown, CPC, OCS