CPT Knowledgebase - Apr 5, 2021

How should a new patient office visit for male sterilization counseling performed one day before a vasectomy be reported? For example, some payer(s) may reject the E/M visit claim reported without a modifier if the counseling is performed the day before the procedure; however, an E/M visit claim will be accepted if the counseling is performed at least 2 days before the vasectomy. Is the day before the vasectomy included in the global period? If so, should Current Procedural Terminology (CPT ) modifier 25 or 57 be used when reporting the E/M code?

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