Wiki Decision for surgery -57

[bill2doc]

I am using modifier -57 on 99223 which during the visit it is decided to do the surgery. Why is Medicare not paying for this ??????

 

[jweyand]

Major surgery has to take place same day as visit or day after to use -57. For minor surgery that takes place on same day as visit, can't use -57. Another reason it could be denied is if procedure is multiple stages.
Don't know your specifics, but hope this helps..

 

[sferguson]

Medicares post op bundling starts 1 day prior and 90 days after.

 

[madcomic2000]

What procedure are you billing for? If it's a 90 day global, then the 57 is appropriate. If it's a 0 or 10 day global, you would use modifier 25 if it's the same day only.

 

[bill2doc]

Can I use -57 if it's minor 10 day but procedure was following day?