cwilson3333
Expert
When my doctor sees a patient in the office, following surgery by the on-call physician for fracture of hip, I add modifier "55" to the surgical code, to indicate that this is for post surgical care only. I know the surgeon who performed the surgery is supposed to use a "54" on his claim to indicate surgical care only.
My claims with the modifier "55" are getting denied. I am using the surgical code and actual date of service on the claim, also.
Is there other information that I need on the claim? I haven't gotten billing information from the surgeon performing the surgery as he is only an on-call surgeon from another area.
Would appreciate some advice on how I can get these types of claim paid.
My claims with the modifier "55" are getting denied. I am using the surgical code and actual date of service on the claim, also.
Is there other information that I need on the claim? I haven't gotten billing information from the surgeon performing the surgery as he is only an on-call surgeon from another area.
Would appreciate some advice on how I can get these types of claim paid.