tci General Surgery Coding Alert - 2006 Issue 7

Think Twice About Modifier 55

Coordinated coding is necessary to receive payment When a different physician removes sutures than the one who placed them, you may be tempted to apply modifier 55. Although you might argue successfully that you can apply the modifier in this case, you will want to proceed with caution. Modifiers 54 and 55 Must Work Together You may apply modifier 55 (Postoperative management only) to identify the postoperative management when a different physician performs the surgical procedure, according to CPT guidelines. In practice, this could mean, for instance, that you could report suture removal separately with modifier 55 if...

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