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Thread: H&P's on same day as surgery

  1. #1
    Join Date
    Apr 2007

    Question H&P's on same day as surgery

    AAPC: Back to School
    Hope someone can clear up some ocnfusion on my end.

    If H&P is done "same" day as a surgical (global) procedure can we still bill out H&P w/57 modifier appended?

    I am under the impression the H&P would be considered " global" to surgical procedure if done on the same day.

    Can anyone advise?

    Thanks in advance!

  2. #2

    Default M

    As long as the decision for surgery (major procedure) was made on that day you can append the E/M code with a -57 modifier to allow for payment. However, some insurance companies will not pay even with the modifier.

    Good Luck!
    Dee CMA, CPC

  3. #3
    Join Date
    Apr 2007


    yes i agree with the last post. Not sure if medicaid takes modifier 57

  4. #4
    Join Date
    Apr 2007
    Milwaukee WI

    Default Scheduled surgery vs emergent surgery

    If this was a scheduled surgery ... No, you cannot code the Initial Hospital Visit. Your decision for surgery was made at a prior office or clinic visit.

    If this was an emergency surgery, then yes, you may use the -57 modifier to signify that your E/M resulted in the decision for surgery.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

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