AMA CPT® Assistant - 1997 Issue 6 (June)
Modifiers, Decision for Surgery, -57 (Q&A) (June 1997)
June 1997 page 11b Coding Consultation Modifiers, Decision for Surgery, -57 (Q&A) Question In the May 1997 Modifier Issue of the CPT Assistant , the illustration provided for the use of modifier -57, Decision for Surgery, used a consultation E/M visit as an example of the type of E/M service provided. Is the -57 modifier restricted to use with consultation E/M codes only ? AMA Comment No. The -57 modifier is not limited to use with the consultation E/M codes. As the definition of the -57 modifier states: "An evaluation and management service that resulted in the initial decision to...
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Article Overview
This article addresses a coding question from CPT Assistant about modifier -57 and whether its use is limited to consultation E/M services. It is intended for coding professionals who need a better understanding of how the modifier is discussed in the context of CPT guidance and evaluation and management reporting.
Why This Topic Matters
It helps coders and auditors interpret a specific CPT modifier discussion consistently when reviewing E/M services associated with surgery-related decision-making.
Article Sections
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Coding Consultation
A short Q&A format presenting a coding question and an AMA response within the CPT Assistant consultation context.
What You Will Learn
- The general CPT Assistant topic addressed in the Q&A
- How the article frames modifier-related guidance for E/M services
- The context in which a surgery-related decision modifier is discussed
- Why the issue arose from an earlier CPT Assistant example
Who Should Read This
- Medical coders
- Coding auditors
- Billing compliance staff
- Physician practice coding staff
Modifiers Discussed
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