Modifier 56- Preoperative Management Only

Modifier 56 is used when a physician provides only the preoperative management portion of a surgical service.

What is Modifier 56?

Modifier 56 tells insurance payers that the provider performed only the preoperative management related to a surgical procedure.

When to Use Modifier 56

• Preoperative care is provided
• Another physician performs the surgery
• Shared surgical care arrangements exist
• Documentation supports preoperative services

Billing Example

A physician evaluates and prepares a patient for surgery, but another surgeon performs the operation. Modifier 56 may be appended when appropriate.

Documentation Tips

• Document preoperative evaluations
• Identify the operating surgeon
• Maintain consultation records
• Support medical necessity

Common Denial Reasons

• Missing preoperative documentation
• Incorrect modifier usage
• Incomplete records
• Shared care not documented

Related Modifiers

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