54 - JF Part B
Surgical Care Only. When a physician or other qualified health care professional performs a surgical procedure and another provides preoperative and/or postoperative management, surgical services may be identified by adding this modifier to the usual procedure code.
Use to explain that the surgeon performed the surgical procedure only and is relinquishing a part or all of the postoperative days to another physician.
- Surgeon performs surgery only
- Bill surgical date of service
- Append to surgical code
- Do not append modifier 54 if patient is under surgeon's care for the full 10 or 90 days of postoperative care
- Do not append on ASC facility or assistant surgeons services
Claim Coding Example
An orthopedic surgeon performs an open tibial shaft fracture (27759) but relinquishes care to another physician for postoperative care.
Dr. Smith (Surgeon)
|3/9/16||Open tibial shaft fracture||27759 54||1|
- CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Publication 100-04, Chapter 12, Section 40.2
Last Updated Mon, 24 Oct 2022 20:07:22 +0000