Medicare Compliance & Reimbursement

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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