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CPT codes, descriptions, and other data only are copyright 2008 American Medical Association (or such other date of publication of CPT). All Rights Reserved. Applicable FARS/DFARS Apply.

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West Virginia Part B Carrier
Pre/Post Operative Care: Date of Service

When physicians agree on the transfer of care during the global surgery period, the following modifiers must be used:
  • CPT Modifier 54 - for surgical care only
  • CPT Modifier 55 - for postoperative management only
The claim for the surgical care and the claim(s) for the postoperative care must contain the same date of service and the same surgical procedure code with the services distinguished by the use of the appropriate modifier.

Appropriate

DateCPT code/modifierSurgeon/Physician
5/8/07 66982-54 Surgeon
5/8/07 66982-55 Post-op Care Physician

Inappropriate

DateCPT code/modifierSurgeon/Physician
5/8/07 66982-54 Surgeon
5/9/07 66984-55 Post-op Care Physician

The surgeon and the physician(s) providing the post-operative care must collaborate to ensure the appropriate date of service and surgical code are submitted (with the appropriate CPT modifier).

Claims are being monitored and will be rejected when submitted inappropriately.

For more information regarding global surgery and transfer of care during the global surgery period, refer to Sections 40.2 - 40.4 (PDF, 902 KB).

 

last updated on 11/05/2008
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