Orthopedic Coding Alert
Modifier -57
Anonymous IN Subscriber
Answer: Yes. Modifier -57 (decision for surgery) is to be applied to any E/M service, whether new or established patient, inpatient or outpatient consultation, when the decision to perform surgery has been made. The modifier was designed to allow for payment in those circumstances when otherwise the E/M service would be considered bundled, specifically the day before or the day of surgery. Some carriers, however, will still deny the E/M service. Contact any specific carriers to check their requirements. Many will need to see the E/M documentation prior to the payment
Orthopedic Coding Alert
- How to Correctly Bill When a Diskectomy and Arthrodesis are Performed at the Same Time
Laura Nuechterlein, MPA, senior policy analyst for the American Academy of Orthopedic Surgeons (AAOS) reports [...] - Optimize Coding for Joint Injections by Knowing What to Bill with the Injection Code
"Arthrographies and anesthetic injections can cause confusion when it comes to coding because there is [...] - Reimbursement Issues over Bunionectomies Combined with Hammertoes
When bunionectomies and hammertoes are billed together, there can often be problems getting paid. Annette [...] - How to Properly Code for Post-emergency Fracture Care
Proper coding for post-emergency fracture care presents an array of reimbursement challenges for orthopedic practices. [...] - Reader Questions:
Epidural Steriod Injections
Question: We would like clarification on how to bill epidural steroid injections to Medicare. We [...] - Reader Questions:
Salter Type II
Question: A patient is placed on the operating table in the supine position. After adequate [...] - Reader Questions:
Interpretation of X-rays
Question: One of our physicians bills for interpretations of previously taken x-rays brought in with [...] - Reader Questions:
Attempted ORIF
Question: In your August 1999 issue of Orthopedic Coding Alert, there is a reader question [...] - Reader Questions:
Second Opinion
Question: If a patient is in the global period for an arthroscope by a physician [...] - Reader Questions:
H & P on All Surgeries
Question: The hospital requires an H&P on all surgeries, including staged procedures. Can we bill [...] - Reader Questions:
Two Sets of X-rays?
Question: Can we charge for two sets of x-rays when a fracture is reduced in [...] - Reader Questions:
Modifier -57
Question: Can using modifier -57 help us get reimbursed for performing a consult or an [...]
