tci General Surgery Coding Alert - 2002 Issue 10

Modifier -57 Gains Payment for Preoperative Exams

Medicare guidelines stipulate that evaluation and management services provided the day before or the day of a major surgery (i.e., a surgery with a 90-day global period) are included in the surgery's global package and are not separately reimbursable. If the preoperative exam prompted the decision for surgery, however, separate reimbursement is warranted and may be achieved if the visit is properly documented and modifier -57 (Decision for surgery) has been appended. 'Global'Services Versus Decision for Surgery According to Medicare's global surgery rules, payment for surgical procedures includes the surgery itself (the intraoperative"" portion of the service)" as...

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