Modifiers 54-55, split surgical and postoperative care

January 4th, 2018 - Find-A-Code
Categories:   Modifiers   Documentation Guidelines  
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54 -Surgical care only; Surgeon is performing only the preoperative and intra-operative care

55 - Postoperative management only; Physician, other than surgeon, assumes all or part of postoperative care

Modifiers should be placed on the surgical code

Used on 10 day and 90 day surgical procedures

Both the surgeon and the physician providing the postoperative care must keep a copy of the written transfer agreement in the beneficiary’s medical record. When a transfer of postoperative care occurs, the receiving physician cannot bill for any part of the global services until he has provided at least one service. Once the physician has seen the patient, that physician may bill for the period beginning with the date on which he assumes care of the patient. 

Coverage chart-CPT Modifiers 54 and 55

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