Ob-Gyn Coding Alert

Question: In our ob-gyn office, we used to apply modifier 57 to inpatient consult codes. Now that Medicare doesn't accept consult codes, how should we use this modifier? Kentucky Subscriber Answer: The short answer is that you should appendmodifier 57 (Decision for surgery) to the non-consult inpatient E/M code that the documentation supports. Suppose the ob-gyn performed a 2009 level-three inpatient consult in which the ob-gyn determined the patient required an exploratory laparotomy later that sameday due to severe abdominal distention and pain as well as some uterine bleeding. Adding the modifier to the E/M code will help show payers why you're reporting an E/M in addition to the major surgery performed later that day, 49000 (Exploratory laparotomy, exploratory celiotomy with or without biopsy[s] [separate procedure]). For 2010, the exact E/M code you choose will depend on the circumstances specific to the visit, such as whether the visit is the [...]