Splitting Postoperative
Care
- The physician who performs one day of preoperative
care, intraoperative care, and any in-hospital visit
performed on the day of surgery should report the 54
modifier.
- The physician who performs only the postoperative
care should bill with the date of the surgery,
procedure code for the surgery, and a 55 modifier.
- The total number of days reported in Physician A
and B’s ranges should equal the total number
of postoperative days for the procedure.
- In those cases where postoperative care is
"split" between physicians, the billing
should be reported as:
Physician A
- Line 1 – date of surgery, surgery code
with 54 modifier
- Line 2 – date of surgery, surgery code
with 55 modifier
Narrative Field or Item 19
Range of dates that the postoperative care was
provided. If the physician (surgeon) does only one day of
post-op care, then he needs to put 10/21/2004 to
10/21/2004 or "one day of post-op care" in Item
19 or narrative equivalent.
Physician B
Date of surgery as service date, surgery code with 55
modifier, and range dates when responsible for post-op
care.
EXAMPLE
An ophthalmologist (Dr. A) performs cataract surgery
(66920) on October 10, 2004 and performs three days of
postoperative care. The optometrist (Dr. B) then takes
over the care of the patient for the remainder of the
post-op period.
| Item 24: |
10/10/2004 |
66920-54 |
|
10/10/2004 |
66920-55 |
| |
|
|
| Item 19 or Narrative: |
10/21/2004
–10/24/2004 |
Posted: 10/18/2004
[ ]
|
