Renee Posted Tue 14th of March, 2017 12:10:02 PM
How do we bill claims for postoperative follow up care if we do not have a written "transfer of care" notice from the provider who did an operation? we have many patients who are injured while out of town, then come back home & need to follow up. do I still bill the operative cpt code with the -55 mod & indicate the primary surgeon & list the post op care dates? or do I bill as a new patient with an E&M code? thank you
SuperCoder Answered Wed 15th of March, 2017 06:00:13 AM
Renee Posted Tue 21st of March, 2017 14:28:59 PM
is this a choice that the provider has? whether to bill the surgical code with a -55modifier OR to bill office visits with xrays? or is it simply that the appropriate coding for assuming care after a surgery is to bill post op care only?
SuperCoder Answered Wed 22nd of March, 2017 13:32:21 PM
If we do not have written documentation of "transfer of care", it is appropriate to bill E/M with xrays. Patient service would be considered as new patient E&M. However, if "transfer of care" is documented, we will use modifier 55 with the CPT procedure code for global periods of 10 or 90 days. Thank you