Reader Questions:
Modifier -57
Published on Wed Sep 01, 1999
Question: Can using modifier -57 help us get reimbursed for performing a consult or an admission on the same day the surgery is performed?
Anonymous IN Subscriber
Answer: Yes. Modifier -57 (decision for surgery) is to be applied to any E/M service, whether new or established patient, inpatient or outpatient consultation, when the decision to perform surgery has been made. The modifier was designed to allow for payment in those circumstances when otherwise the E/M service would be considered bundled, specifically the day before or the day of surgery. Some carriers, however, will still deny the E/M service. Contact any specific carriers to check their requirements. Many will need to see the E/M documentation prior to the payment
