What does modifier -54 indicate when used for Colle's closed reduction?

What does modifier -54 indicate when used for Colle's closed reduction?

• A. The physician performed only the surgical part of the procedure
• B. The procedure will be fully reimbursed
• C. The patient requires emergency treatment only
• D. The provider will perform follow-up care

Answer: (A)

Modifier -54 is used to indicate that the physician performed only the surgical portion of a procedure, specifically when the procedure is typically divided into surgical, pre-operative, and post-operative components. In the case of Colle's closed reduction, if the surgeon is only responsible for the surgical intervention and not for the pre-operative evaluation or post-operative management, the use of modifier -54 accurately reflects that. This modifier ensures appropriate billing and reimbursement, as it signals to the insurance payer that the physician’s role was limited to the surgical aspect, excluding the management of the patient before and after the procedure. It clarifies the level of service provided, which is essential for proper coding and claiming processes in healthcare.

Modifier -54 is used to indicate that the physician performed only the surgical portion of a procedure, specifically when the procedure is typically divided into surgical, pre-operative, and post-operative components. In the case of Colle's closed reduction, if the surgeon is only responsible for the surgical intervention and not for the pre-operative evaluation or post-operative management, the use of modifier -54 accurately reflects that.

This modifier ensures appropriate billing and reimbursement, as it signals to the insurance payer that the physician’s role was limited to the surgical aspect, excluding the management of the patient before and after the procedure. It clarifies the level of service provided, which is essential for proper coding and claiming processes in healthcare.