tci Part B Insider - 2004 Issue 22

MODIFIERS: For Pre-Operative E/M Visit, Intent Determines Your Modifier

Use -57 modifier only if the visit was directly related to the surgery If your surgeon has an evaluation and management visit with a patient within one day of a surgery with a global period, you may need to use a modifier to obtain payment for that visit. But which modifier? If the visit involved the decision to operate on the patient, then you can use the -57 modifier (Decision for surgery). But if the E/M wasn't actually related to the surgery, then you can use the -25 modifier (Significant, separately identifiable evaluation and management service by the same...

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