mod 57 - day as surgery

RebeccaWoodward*

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Brandi,

I think the poster means H&P...

Yes...if this is a major surgery and the need for surgery was made the day of/day before, the H&P is billable. You would need to add modifier 57 to your E/M code.

B. Services Not Included in the Global Surgical Package

"The initial consultation or evaluation of the problem by the surgeon to determine the need for surgery. Please note that this policy only applies to major surgical procedures."

http://www.cms.gov/manuals/downloads/clm104c12.pdf

Section: 40.1
 
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