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modifier 25/57

  1. #1
    Default modifier 25/57
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    I work for GI docs and we have an on-site surgery center for colonoscopies and EGD's, etc...If a patient comes in for office visit and they decide to do a procedure the next day, does the office visit need a 57? Thanks in advance!!

  2. #2
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    Quote Originally Posted by anknight77 View Post
    I work for GI docs and we have an on-site surgery center for colonoscopies and EGD's, etc...If a patient comes in for office visit and they decide to do a procedure the next day, does the office visit need a 57? Thanks in advance!!
    Yes, it needs a 57, when the surgery is on a subsequent date. You'd use a 25 modifier if the surgery was on the same day, and was a minor surgery (0 or 10 day global) -

    [Note: You can technically use a 57 when the decision and surgery are on the same day, too, but generally it's for procedures with 90 day globals. 25 is also (usually) acceptable under those circumstances] Hope that helps!

  3. #3
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    Thanks so much!!!

  4. #4
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    Quote Originally Posted by anknight77 View Post
    I work for GI docs and we have an on-site surgery center for colonoscopies and EGD's, etc...If a patient comes in for office visit and they decide to do a procedure the next day, does the office visit need a 57? Thanks in advance!!
    Quote Originally Posted by btadlock1 View Post
    Yes, it needs a 57, when the surgery is on a subsequent date. You'd use a 25 modifier if the surgery was on the same day, and was a minor surgery (0 or 10 day global) -

    [Note: You can technically use a 57 when the decision and surgery are on the same day, too, but generally it's for procedures with 90 day globals. 25 is also (usually) acceptable under those circumstances] Hope that helps!
    Brandi,

    Do colonoscopies and EGDs count as surgeries? Aren't they 0 (zero) day globals?

    Thanks,
    Ron McKenzie, CPC-A
    Greater Orlando FL Chapter

  5. Default
    I agree...57 is for 90 day globals

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