I work in a very large group practice located through a large geographic area in the State. I do not perform foot or ankle surgery. However, if I were to refer a patient within the practice to a foot/ankle surgeon who travels to my locale to perform the surgical consultation and the surgery and then, I choose to provide the post-operative care is referred back to me to manage and I able to bill for those post-op services? Or is that part of the global period? I understand that I would need to use the modifiers -54 or -55 to indicate on the CMS-1500 claim who's doing the post operative care and or surgery, correct? Can you allude to the possible medicolegal ramifications if a physician is only participating in the post-op care.
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I know that our Medicare carrier, Novitas Solutions, has some definite rules regarding those modifiers. There are also definite documentation requirements that are important. I don't know about other carriers, but here is the link to Novitas' specific policy:
https://www.novitas-solutions.com/webcenter/portal/MedicareJL/pagebyid?contentId=00101754.