tci Outpatient Facility Coding Alert - 2014 Issue 4

Reader Question: Check for Transfer of Care Before Appending Modifier 55

Question: If another otolaryngologist, not the physician who performed the surgery, sees a post–op patient and admits him to the hospital during the 42–day global period, is modifier 55 appropriate? California Subscriber   Answer: If another otolaryngologist takes charge of all the postoperative care of a patient within the 42-day global period, then you can claim that care by appending modifier 55 (Post operative management only) to the applicable CPT® procedure code. Key note: Verify that the originating surgeon has done a formal transfer of care to the otolaryngologist for the postoperative care. When you complete the...

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