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

Study for the AAPC CEMC exam with our comprehensive quiz material, flashcards, and multiple choice questions. Gain insights with detailed explanations and hints to help you prepare effectively for the test.

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.

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