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E/M visit in ED with surgical proc same day

  1. #1
    Default E/M visit in ED with surgical proc same day
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    Does anyone have any information on billing 99285/57, 27810/54 & 99144. My thought was to bill the E/M visit with a modifier 25 instead of modifier 57. My thinking is, the reduction was bill with modifier 54, telling the insurance there is going to be no post op care by this provider. I don't know of any guideline to this effect, it just seems by taking the post op care out of the reduction, it would make it a minor procedure.

    Please let me know.

  2. Default
    Bill with modifier 57.It is still a decision for major surgery that carries a 90 day global with most carriers. He will obviously not get paid for the whole global package, but he did the intraoperative care for major surgery, so he get most of the payment.
    Clara Therio, CPC

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