tci Medicare Compliance & Reimbursement - 2014 Issue 11

Modifier 57 Checklist

Use for E/M services only. Use when an E/M service results in a surgery. Make sure the E/M service relates to the surgery. Use when the surgery is major, with a 90-day global period. Ensure the E/M and surgery occurred on same day or E/M was the previous day. Use when the same physician (or ID#) provides the E/M service and performs the surgical procedure.  ...

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