Forum - Questions & Answers

Jul 26th, 2014 - rosemedical

post op icd 9 and CPT® codes after surgery

Need to bill of drain and staples removal by physician other than performing surgeon.
Patient still in post op period.

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Jul 27th, 2014 - LBAROGIANIS 250 

re: post op icd 9 and CPT® codes after surgery

THIS IS WHAT CMS SAYS: BUT YOU NEED TO COORDINATE WITH THE SURGEON.
Global Surgical Split Billing (Transfer of Care between Providers)
If different physicians perform portions of the global service, modifiers should be used with the
surgical procedure code having a 90 day postoperative period to indicate what portion of the
service each provided. Each physician will be reimbursed a percentage of the global fee. The
percentages allocated for pre-operative, intra-operative and post-operative services will vary for
each surgical procedure. The sum of the amount approved for all physicians may not exceed
what would have been paid if a single physician provided all services.
-54 Surgical Care Only: When one physician performs a surgical procedure and another
provides postoperative management, surgical services may be identified by adding
modifier -54 to the usual procedure number.
-55 Postoperative Management Only: When one physician performed the postoperative
management and another physician performed the surgical procedure, the postoperative
component may be identified by adding modifier -55 to the usual procedure number.
Physicians who share postoperative management must coordinate their billing. Physicians who
share postoperative management with another physician must submit information on their
claims showing when they assumed or relinquished responsibility for the postoperative care. In
item 19 of the Form CMS-1500 or the electronic equivalent enter “Assumed Post-op
Date=MM/DD/CCYY” or “Relinquished Post-op Date = MM/DD/CCYY.” Enter 1 unit of
service.
RELINQUISHED POSTOP DATE = 5/2/10
813 43
04302010 04302010

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