Modifier:
Modifier 57: Life After Elimination of Consult Codes
Published on Wed May 18, 2011
Another modifier may grace your claim when describing principal physician service. Find out what. Contrary to popular thinking, modifier 57 does not apply exclusively for consultation codes only. Medicare may have stopped paying for consult codes, but this doesn't mean you have to stop using modifier 57. Here are 2 tips on how you can use this modifier to suit your practice's needs. Background: Starting January 1, 2010, the Centers for Medicare and Medicaid Services (CMS) eliminated consult codes from the Medicare fee schedule. Non-Consult Inpatient Codes Keep Modifier 57 Alive With CMS eliminated consult codes (99241-99245, 99251-99255) for Medicare patients, you might have wondered if modifier 57 (Decision for surgery) would remain useful. The answer? You can still use this modifier for a non-consult inpatient E/M code, so long as your documentation supports it. This is because any major procedure includes E/M services the day before and the day [...]
