Radiology Coding Alert

Question: "Considering Mod 57? Check Global Period," in Radiology Coding Alert, Vol. 11, No. 14, discusses a case in which you append modifier 57 to an inpatient consult code. How should you code the case now that Medicare doesn't accept consult codes?Illinois SubscriberAnswer: The short answer is that you should append modifier 57 (Decision for surgery) to the non-consult inpatient E/M code that the documentation supports.The case you reference involved a 2009 level-three inpatient consult in which the radiologist determined the patient required an inferior vena cava (IVC) filter placed later the same day. Adding the modifier to the E/M code helps show payers why you're reporting an E/M in addition to the major surgery performed later that day, represented by 37620 (Interruption, partial or complete, of inferior vena cava by suture, ligation, plication, clip, extravascular, intravascular [umbrella device]).The exact E/M code you choose will depend on the circumstances specific [...]