tci General Surgery Coding Alert - 2006 Issue 12

Reader Question ~ Choosing a Modifier for 2 Services

Question: We performed an inpatient consultation and decision for esophagogastroduodenoscopy (EGD) on the same day. The carrier denied the consultation and paid for the EGD only. Should we have used modifier 59?Pennsylvania Subscriber   Answer: You can append modifier 25 (Significant, separately identifiable E/M service by the same physician on the same day of the procedure or other service) to E/M codes when your physician provides the service on the same day as a procedure that has a global period of 10 days or fewer (minor procedure). You would use modifier 57 (Decision for surgery) with E/M codes...

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