tci Medicare Compliance & Reimbursement - 2017 Issue 20

Modifiers: Master Modifier 57 to Boost E/M Pay With Procedures

Tip: Global days factor into whether to use modifier 25 or 57. Many practices are reluctant to use modifier 57 (Decision for surgery) for fear of over-billing for E/M services. But knowing the correct situations to use the modifier can help you file more accurate claims, and capture all the pay you deserve. Read on to get our experts' tips about when and how to use modifier 57. Focus on Core Meaning of 57 When you're evaluating a patient and determine during the visit to perform surgery that day or the next day, you'll need to append modifier 57...

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