What type of care does Modifier 55 refer to?

Modifier 55 is specifically used to indicate postoperative care that is provided after a surgical procedure has been completed. This modifier is applied when a physician is responsible for the follow-up care but is not the one who performed the actual surgical operation. It is essential to delineate these services for accurate billing and to reflect the division of responsibilities for patient care.

In the context of medical billing and coding, postoperative care includes services like follow-up visits, management of complications, and wound care, ensuring that the patient’s recovery is properly monitored and managed. This modifier helps in documenting that certain aspects of care were transferred to another provider who assumes responsibility for the patient's recovery.

Understanding this modifier's use is crucial for providers and coders as it can impact reimbursement processes and the overall documentation of patient care. It indicates that the care is essential to the patient's recovery process following surgery but does not include the initial surgical care itself.