Wiki Modifier 57 vs 25

[clopez]

Hello,

I need some clarification on 57 vs 25 used on same day of a separate E/M and closed treatment is provided. Which modifier is appropiate 57 or 25.

My logic is that although the closed treatment of a fracture have 90 day global it's not an invasive surgery, so 25 would be appropriate.

57 I see appropriate when decision for an open treatment is made on the same day or next day.

Orthopedic doctors rendeing the services.

Thank you!

Cindy CPC

 

[thomas7331]

Medicare and most other payers, in my experience) go by the global days to distinguish between a major and minor procedure, not by whether the procedure is invasive or not.

 

[philipwells]

Agree with the previous response. It's all about the global days

10 days - 25 mod
90 days - 57 mod

 

[clopez]

I thank each one for your response.