We have physicians and PA's that see pts inpatient for and E/M. they are sending me notes for subsequesnt visit and procedure( colo or egd) on the same day. I am confused at to what modifier to use or if I can even charge and e/m visit. We have been debating this in our office and I need some clarification. for Example pt had consult on 6-28-14 subsequent visit on 6-29-14 and on 6-30-14. Dr. also performed a colonoscopy on pt 6-30-14. Previous coder in our office did not use -57 at all to my knowledge and may have used -25. I am new to coding hospital visit and procedures. Any help is greatly appreciated.