Billing Post-Operative Care Management

Follow these billing/coding tips for smooth claims processing.

• Modifier 55 is used to report postsurgical care
• Modifier 54 is used to report surgical care only
• Modifier 54 and 55 should never be reported together
• Date of Service should be the date of surgery with assumed and relinquished date submitted in box 19 of the claim form or EDI equivalent field.
  • The relinquished date should be the last date that care was provided.
• Units should be billed as 1. Do not report days of care as the units.