HELP!
I have a question about modifiers 54, 55 & 56. I work in an ortho office and our office will have a new physician joining us. He is currently doing surgery and taking call for the local hospital. He will be seeing patients in our office in follow up of surgeries he did at the hospital. He will be an employee of the hospital for the surgery and an employee of our office for the follow ups.
My managers (neither of which have ANY credentials) have instructed me that when I bill for the physician services in our office that I will need to use the 55 modifier (postoperative management only) for his follow up visits on patients he sees in our office. They have told me that this is ok because the hospital will be billing his charges for surgery with a 54 (surgical care only). Supposedly they have called Medicare and were told this was "fine". I have asked to see this in writing, but have not seen anything yet.
If you read the descriptions on these modifiers, it says "ONE" physician performs the surgery and "ANOTHER" physician performs the follow up. It just does not seem right to me.
I am going to need reference material to help me prove my point if I am correct.
Thanks in advance for your help!
Chris Lee
I have a question about modifiers 54, 55 & 56. I work in an ortho office and our office will have a new physician joining us. He is currently doing surgery and taking call for the local hospital. He will be seeing patients in our office in follow up of surgeries he did at the hospital. He will be an employee of the hospital for the surgery and an employee of our office for the follow ups.
My managers (neither of which have ANY credentials) have instructed me that when I bill for the physician services in our office that I will need to use the 55 modifier (postoperative management only) for his follow up visits on patients he sees in our office. They have told me that this is ok because the hospital will be billing his charges for surgery with a 54 (surgical care only). Supposedly they have called Medicare and were told this was "fine". I have asked to see this in writing, but have not seen anything yet.
If you read the descriptions on these modifiers, it says "ONE" physician performs the surgery and "ANOTHER" physician performs the follow up. It just does not seem right to me.
I am going to need reference material to help me prove my point if I am correct.
Thanks in advance for your help!
Chris Lee