READER QUESTIONS:
Check Major Vs. Minor for Mod 57
Published on Sat Sep 26, 2009
Question: The cardiologist performed a level 3 consult for an inpatient and determined the patient needed an IVC filter (37620) placed later that day. Should I append modifier 57 to the E/M code? South Carolina Subscriber Answer: Yes, you should append modifier 57 (Decision for surgery) to 99253 (Inpatient consultation for a new or established patient ...) in this case. CPT's modifier 57 definition states you should append it to an E/M "service that resulted in the initial decision to perform the surgery," as in your example. 'Major' must: Medicare instructs contractors that you should use modifier 57 only with major surgeries, which are procedures with a 90-day global period. The Medicare Physician Fee Schedule assigns a 90-day global period to 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]). And Medicare instructs carriers that E/M services "on the day before [...]
