Wiki mod 55 for all post op or one visit?

[zoolug]

I work for a university student health service. We often do dressing changes after a student has surgery, for example CPT 10060. So we get the plan of care from the surgeon and bill 10060 mod 55. The question is, by doing that are we billing for all post op care within the global period or for just that one visit? Some insurances have paid multiple visits w/55 mods for the same surgery. BCBS, however denied our second 10060 mod 55 as global to the first and sustained the denial upon appeal. I am inclined to agree with their logic and accept the denial.

Any opinions?

Thanks,
Paul

 

[FTessaBartels]

mod -55

When you use the Mod -55 you are accepting care for the entire global period of the procedure performed (10 days or 90 days). You code the procedure ONCE with a -55 modifier, then 99024 for subsequent F/U visits during the global period.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[zoolug]

makes sense

Makes sense. Thanks.

-Paul