Wiki Modifier 57 with Hosp Consult

[jlb102780]

I have a general question. I do the hospital billing for a group of Cardiologist. I've always been told that if they see a pt for a consult and decide to do a procedure like a cardiac cath on the pt, the 57 mod goes on the consult code. I read an article recently that said to put the 57 on the surgery codes. Can someone clarify this for me. Thanks

Jammie Mack, CPC

 

[mitchellde]

57 is an E&M modifier only so it goes on the consult code in your scenario. Where was this article?

 

[LLovett]

57 is only an E/M modifier but I think what they may be talking about is only using it when the procedure done (ie surgery) has a global period.

57 gets you out of the global period, if there is no global period you would not need it.

Laura, CPC, CEMC

 

[charityelaine]

Hi Jammie. I agree with Laura. You do not need to append the -57 modifier unless the cardiologist is doing something like an insertion of a pacemaker (or something else with a 90 day global period). I also code cardiology and I don't put the -57 modifier on heart caths...they pay just fine.

Charity Brown, CPC

 

[jlb102780]

Thanks so much for the replies.

Jammie Mack, CPC

 

[SherryMoss]

My understanding is/was that the modifier goes on the E&M service, however, if the procedure has a 10-day global, you use a -25 modifier. If the procedure has a 90-day global, you use -57.

Am I just having a senior moment (again!)?