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Wiki Er visit with surgery

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annettebec

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Swartz Creek, MI
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Er physician see patient and decides to repair a simple laceration and an intermediate laceration. Do i code an er visit and append mod 57 or is the er visit included in the repairs. Thanks for your help.
 
Visit and LAC repair may both be billed. Intermediate LAC repair codes are not MAJOR procedures (90 follow up days), so Medicare will not pay for the 57 modifier on the E/M charge - use a 25 instead.

Even though CPT does not specifiy that the 57 modifier is only to be used for MAJOR procedures like Medicare does, the 25 modifier would be more appropriate in this case.


Maryann
 
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