Neurosurgery Coding Alert

Question: My physician is adding modifier -57 to all E/M visits when he makes the decision for surgery, even when surgery is a week or more away. Is this correct?

Oregon Subscriber

Answer: Adding modifier -57 (Decision for surgery) to an E/M service performed before the global preoperative period begins is incorrect. You should use modifier -57 to lift an E/M service performed the day of or day before major surgery out of the global package when the decision for surgery resulted during that encounter. You needn't append it to an E/M service not performed during the 90-day global period.