Orthopedic Coding Alert

Reader Question:

Modifier and E/M Visits

Question: My physician is adding modifier -57 to all E/M visits where the decision for surgery is made, 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 that is performed before the global preoperative period begins serves no purpose. Modifier -57 should be used 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. It does not need to be appended to an E/M service that is not performed during the global period.
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