tci E/M Coding Alert - 2018 Issue 3

Reader Question: Decide the Best Way to Use This E/M-Specific Modifier

Question: When are you supposed to report modifier 57? Is it a modifier for evaluation and management (E/M) services or procedures? Maryland Subscriber Answer: When the provider performs an E/M service for a patient that leads to surgery that day (or in the near future), you'll likely append modifier 57 (Decision for surgery) to the E/M code, relays Catherine Brink, BS, CMM, CPC, president of Healthcare Resource Management in Spring Lake, New Jersey. Never apply modifier 57 to a procedure code; it's for E/Ms only, and only in specific circumstances. The 57 modifier separates patient E/M encounters from major...

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