A patient had surgery with another physician not affiliated with our office for a fracture and is following up with our physician just for post op care. Can our physician bill a fx tx code with modifier 55 or is it to be coded as a post op follow up visit, if anyone can help i would appreiciate it.
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Wiki Fx tx?
- Thread starter jconn
- Start date
mitchellde
True Blue
you should use the same code the other physician used for the surgery with the 55, this is assuming that the other physician requested that you do the followup care. If this is patient decision to followup with you then that is a whole other issue.
LTibbetts
Guest
how would it go down if it was patients decision, say pt is on vacation or just doesn't want to go back to original doc?
mitchellde
True Blue
If the patient is on vacation then it should be no problem to get the treating physician to referr the patient to another doctor for the post op. However if the patient does not wish to return to the treating physician for whatever reason, and the treating physician does not wish to transfer the post op care then you will have to bill the patient for the care you render as an elective patient decision. You cannot bill the patient's insurance since the global was already paid to the treating physician and you cannot bill the back end of his global if he does not transfer that care to you.