Question NPP billing -57 modifier

sbaughcu

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I have surgeons who supervise NPP's to include NPP's making hospital rounds. The NPP's will see the patient and after discussing visit with surgeon a decision for surgery will be made. The surgeon never goes in and sees the patient face-to-face on the visit where decision for surgery is made. Is it proper to bill the NPP's E/M visit with a -57 modifier? I have looked at numerous resources and everything refers to "physician".
Any thoughts?
 

csperoni

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I bill those hospital visits with NPPs with -57 fairly regularly. I have never had an issue.
I believe the exact description of -57 is simply "decision for surgery." My CPT book states 57 Decision for Surgery. Definition: Append modifier 57 to an E/M service if the provider decides to perform surgery the day of the E/M service or the day before.
In this situation, I would interpret a resource stating physician to mean provider. The definition does not state "physician."
 
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