Cardiology Coding Alert

Question: "Check Major Vs. Minor for Mod 57," in Cardiology Coding Alert, Vol. 12, No. 13, described appending modifier 57 to an inpatient consult code. Now that Medicare doesn't accept consult codes, how should we report the case? South Carolina SubscriberAnswer: The short answer is that, for that case, you should append modifier 57 (Decision for surgery) to the non-consult inpatient E/M code that the documentation supports.The case you reference involved a 2009 level-three inpatient consult in which the cardiologist determined the patient required an inferior vena cava (IVC) filter placed later the same day. Adding the modifier to the E/M code helps show payers why you're reporting an E/M in addition to the major surgery performed later that day, represented by 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]).The exact E/M code you choose will depend on the circumstances [...]