Modifier 55- Postoperative Management Only

Modifier 55 is used when a physician provides only the postoperative management portion of a surgical service.

What is Modifier 55?

Modifier 55 tells insurance payers that the provider is responsible only for postoperative care following surgery performed by another physician.

When to Use Modifier 55

• Postoperative care is transferred
• Another provider performed the surgery
• The provider manages recovery and follow-up
• Documentation supports shared care

Billing Example

A surgeon performs an operation and transfers postoperative management to a local physician. Modifier 55 may be appended to indicate postoperative care only.

Documentation Tips

• Document transfer of care dates
• Maintain follow-up records
• Identify the operating surgeon
• Support all postoperative services

Common Denial Reasons

• Missing transfer documentation
• Incomplete postoperative records
• Incorrect billing period
• Modifier used incorrectly

Related Modifiers

Modifier 54

Modifier 56

Modifier 79

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