tci Part B Insider - 2003 Issue 34

Modifiers: Bill Separately for Decision to Operate

Understand the difference between modifiers -57 and -25Before she picks up a scalpel, the surgeon needs to decide to operate on the patient. And this decision deserves its own reimbursement, even if it happens during the day before a surgery preceded by a one-day global period.  But what confuses many coders is which modifier to use for that service:  modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) or modifier -57 (Decision for surgery)? It depends on the circumstances, coding experts say.  When...

To read the full article, sign in and subscribe to tci Part B Insider.


Keep pace with evolving Medicare regulations with timely analysis of critical updates interpreted in an easy-to-follow, easy-to-apply format. Your subscription to TCI’s Part B Insider will equip you to navigate code and guideline changes, CCI edits, and revisions to modifiers, the fee schedule, OIG target areas, and more.

  • Current newsletters added each month
  • Fully searchable archives - over 4800 articles
  • ALL years/issues back to 2003 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.