tci Part B Insider - 2005 Issue 14

Part B Coding Coach: Use Modifier -57 for Same-Day E/M and Major Surgery Services

Reserve modifier -25 for evaluations with minor surgical proceduresIf you're not appending modifier -57 to evaluation and management services (E/M) that lead your surgeon to perform major surgery with a 90-day global period the day of or the day before surgery, you could be cheating your practice out of valuable compensation. Without this modifier attached, carriers can bundle the E/M services into the surgical procedure and deny the surgeon his rightfully earned E/M fee. Meet These 3 Conditions Before You Use Modifier -57 To apply modifier -57 (Decision for surgery), the services the surgeon performs must meet four conditions:...

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