Eli's Rehab Report

Question: My physiatrist treated a patient with a severe headache as an inpatient. He determined that the patient needed a lumbar puncture (LP). Should I append modifier -57 to the consult code? 

South Carolina Subscriber
 
Answer: You should use modifier -57 (Decision for surgery) with an E/M code only when the surgical procedure is a major procedure (or 90-day global) - so in short, no, you should not append modifier -57 to the consult code. The LP (62270, Spinal puncture, lumbar, diagnostic) has a global period of zero days, so it is considered a minor, not a major, procedure.
 
Instead, you should append modifier -25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) to the consultation code because the procedure or service is minor (0- or 10-day global period).