I have provider who is reporting an e&m service (99220) the day prior to AND the day of a major surgery. The provider is appending the e&m code the day of surgery (99232) with mod 57. Is this correct? The observation visit record states "will observe for now, but if not better in the a.m., will consider surgery" The next day, the provider performs an appendectomy. Should both services be allowed? If not, which service should have the -57 modifier?
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Wiki Decision for surgery
- Thread starter rbcarrick
- Start date
valleycoder
Expert
i dont think i would bill the 99232 on day of surgery. it just doesnt seem necessary to me, especially if the surgery was his "next step" in the treatment plan that he outlined on the day he admitted to OBV. Also, i'm not sure of the cpt code for an appendectomy but dont forget to verify that the procedure carries a 90 day global since you are using modifier -57. Otherwise, you would use a -25.
hope that helps!
hope that helps!