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Modifier 57 with Hosp Consult

  1. #1
    Location
    Jacksonville Florida
    Posts
    126
    Question Modifier 57 with Hosp Consult
    Exam Training Packages
    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

  2. #2
    Location
    Columbia, MO
    Posts
    12,561
    Default
    57 is an E&M modifier only so it goes on the consult code in your scenario. Where was this article?

    Debra A. Mitchell, MSPH, CPC-H

  3. #3
    Default
    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

  4. #4
    Location
    Columbus, OH
    Posts
    15
    Talking
    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

  5. #5
    Location
    Jacksonville Florida
    Posts
    126
    Default
    Thanks so much for the replies.

    Jammie Mack, CPC

  6. #6
    Location
    Lauderdale Lakes, FL
    Posts
    19
    Default
    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!)?

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