tci Part B Insider - 2013 Issue 38

Modifiers: This MAC Clarifies Use of Modifiers 54, 55 When Co-Managing Patients

Surgery from one practice and postoperative care from another? It is possible to collect for both. Picture this: A physician diagnoses a hip fracture and performs surgery in Florida, where the patient had been vacationing, then releases the patient, who goes back to her home in Georgia, where a different physician performs all of the postoperative care. Can both physicians collect for their portions of the global surgery fee? The answer is yes—if you know your modifiers. This situation is rather common, and not just for vacationing patients. In some cases, physicians will be unable to perform follow-up...

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