I misunderstood your post when you said you'd still use 57 the day of the procedure - I thought you were referring to this procedure in particular, as opposed to just when to use it, in general. I actually didn't know the 57 was primarily meant for use on major surgeries only, and I can't remember whether I've ever seen it used on the same day or not. (The majority of our providers are family practice/IM, so most of them don't do a whole lot of surgeries. Even if they did, I'm not a coder/biller, so I'd probably never know about it if it didn't deny...)
I got the 'day before' thing, from the CPT Surgical Package definitions, where it says: " Subsequent to the decision for surgery, on related E/M encounter on the day immediately prior to or on the date of procedure (including H&P)".
My thinking was (this may be kind of hard to follow...my logic's a little spacey), the incuded pre-op exam happens after the decision for surgery, so if the pre-op exam is the day before the surgery, then the 'decision for surgery' visit must
also be at least one day before the surgery. I've always used modifier 25 if it all happens at once, because in modifier 25's definition, it says "The E/M service may be prompted by the symptom or condition for which the procedure/service was provided. As such, different diagnoses aren't required for reporting of E/M services on the same date. This circumstance may be reported by adding modifier 25 to the appropriate level of E/M service."
The note right after that is kind of confusing (in the way that it's worded - I understand what it means), where it says, "Note: This modifier is not used to report an E/M service that resulted in a decision to perform surgery. See modifier 57." It sounds kind of contradictory, especially when you consider that nearly all procedures are located in the "Surgery" section of the CPT book, and none of them have their global days listed. As far as I know, the CPT book doesn't define the difference between a "surgery" and a surgical "procedure". It would be nice if they'd clarify it in the book, since their connotations are hard to interpret...Just my two cents!