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tci General Surgery Coding Alert - 2005 Issue 4

Don't Forget the -57 Option for Same-Day E/M Services

Stick with -25 for evaluations with less-intensive services If your general surgeon provides an evaluation and management service that leads to the decision to perform a surgery with a 90-day global period on the same day, be sure to append modifier -57 to the E/M code. Otherwise, payers could bundle the evaluation into the surgery and deny your practice legitimate compensation. 3 Conditions Govern Your -57 Use To apply modifier -57 (Decision for surgery), the services the surgeon performs must meet three conditions:1. the E/M service must occur on the same day of or the day before the surgical...

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