tci General Surgery Coding Alert - 2004 Issue 11

Reader Questions: Forgo -57 for Patients Headed Directly to OR

Question: When should I use modifier -57 (Decision for surgery)? Does this modifier apply to patients admitted to the hospital who go directly to the operating room? Does it apply to patients who receive laceration repair, for instance?Kansas Subscriber Answer: You should append modifier -57 when the E/M service the surgeon performed resulted in the decision for surgery - for example, a surgeon's examination of a patient reveals an immediate need for surgical intervention. However, for Medicare and payers that follow Medicare rules, you should only append modifier -57 to procedure codes that have 90-day postoperative periods...

To read the full article, sign in and subscribe to tci General Surgery Coding Alert.

Leverage vital, to-the-point monthly guidance to boost your reporting accuracy and your coding know-how. We make it convenient for your team to stay informed, compliant, and profitable with a subscription to TCI’s General Surgery Coding Alert.

  • Current newsletters added each month
  • Fully searchable archives - over 2100 articles
  • ALL years/issues back to 1999 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles
Access to this feature is available in the following products:
  • tci General Surgery Coding Alert +Archives

free demo
request yours today
for any budget
sign IN
welcome back!