tci General Surgery Coding Alert - 2016 Issue 4

Reader Question: Check Global Days for Modifier Choice

Question: The definition of modifier 57 is “decision for surgery,” so why do I get notices that this modifier is wrong when I append it to an E/M that leads to a skin biopsy? Iowa Subscriber Answer: The answer has to do with global days. For those payers following Medicare rules, you should append modifier 57 (Decision for surgery) to an E/M code when you report the E/M on the same date as a major surgical procedure or on the day before. A major surgical procedure is one with 90 global days. You can expect to find...

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