DecisionHealth, DecisionHealth - 2019 Issue 4 (April)

‘Do-over’ on this split procedure is probably a start-over, too

Question: An emergency department physician treated a dislocated shoulder reduction (23655) and billed with modifier 54 (Surgical care only), as the patient’s orthopedist would be handling follow-up care with modifier 55 (Postoperative management only). The patient returned to the ED two months later having fallen and dislocated the same shoulder. Our ED physician once again reinserted the shoulder using closed manipulation. How should the second service be reported?

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