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modifer on e/m

  1. #1
    Question modifer on e/m
    Medical Coding Books
    I can see putting a -57mod on an e/m the day of or the day before a
    90 day surgery. Has anyone ever used the mod -57 on an e/m with 1-2weeks
    prior to surgery??

  2. #2
    Duluth, Minnesota
    no..I haven't - why would someone? the .57 helps it get out of the "global" period, (day of/day before) surgery - it makes it clear that THIS visit was a "visit" which turned into a "decision for surgery"... so it shouldn't be bundled with the global period of the surgery... it was "above & beyond" what would be considered part of the surgical package. If the decision for surgery doesn't fall within the "global package" (ie; 2 weeks before actual surgery). it isn't needed...

    curious about others opinions on this...
    Donna, CPC, CPC-H

  3. #3
    Milwaukee WI
    Default Not needed
    I agree with Donna. You don't need the -57 modifier unless your E/M service falls within the 24 hours pre-op surgical package and is the decision for surgery (e.g. patient arrives in ER with lower quadrant pain, is evaluated and decision made to perform emergency appendectomy). The purpose of the -57 modifier is to allow you to be paid for the E/M service that resulted in the decision for surgery, when that E/M service falls within the global period.

    F Tessa Bartels, CPC, CEMC

  4. #4
    Jacksonville, FL River City Chapter
    You can do it, but if applied before the global period begins it serves a tracking function only.

    Seth Canterbury, CPC, ACS-EM

  5. #5
    San Gabriel Valley
    Default modifer on E/M
    57 are for 90 day global. No modifier needed for 10 days and under.

    The only modifier you would use is 25 if you have a two services same day.

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