When should modifier -55 be applied?

Modifier -55 is specifically used to indicate that a physician is taking responsibility for postoperative management only, following a surgical procedure performed by another physician. This modifier is essential in situations where one provider performs the surgery, and a different provider oversees the patient's postoperative care. Thus, modifier -55 allows the physician offering postoperative management to be reimbursed appropriately for their services without disrupting the billing process for the surgical procedure itself.

Applying modifier -55 accurately ensures that the documentation reflects the split of responsibilities: it recognizes the original surgeon's role while also acknowledging the significant ongoing care provided by the physician managing the recovery. Therefore, understanding when to apply this modifier is crucial for proper coding and billing practices in relation to surgical procedures and their respective follow-up care.