decisionhealth Newsletters, Coder Pink Sheets - 2011 Issue 10 (October)
Mind your modifiers: Append 57 only to decision for surgery E/M
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Article Overview
This article explains a Medicare and CPT-focused discussion of modifier 57 and related preoperative evaluation and management billing during the global surgery period. It is aimed at coders, billers, and physician practices that need to understand how official guidance, global package concepts, and payer policy may affect claims for surgery-related visits. The article also references OIG interest in modifier use and cites official CMS and CPT resources.
Why This Topic Matters
Understanding this topic helps practices reduce avoidable claim errors for surgery-related E/M services and stay aligned with payer expectations during the global period. It is especially relevant for organizations reviewing modifier use, surgical billing workflows, and compliance risk.
What You Will Learn
- The general role of modifier 57 in surgery-related E/M billing
- How Medicare and CPT discuss preoperative visits during the global period
- Why payer policy review matters for post-decision preoperative encounters
- What official resources are cited for further reference
Who Should Read This
- Medical coders
- Billing staff
- Compliance professionals
- Surgeons and physician practices
- Practice managers
Codes Discussed
Modifiers Discussed
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