A consultant MAY initiate diagnostic tests or treatment as a result of the consultation. Please look at the guidelines in CPC. (I'm at home and don't have my book with me or I'd quote it for you.)
If the initial visit truly meets the requirements for a consultation, then it is a consult and you would append the -57 modifier if it is also the decision for surgery (and that surgery will be within a couple of days of the consultation visit).
F Tessa Bartels, CPC, CPC-E/M
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