Wiki Modifers 25 and 57

[karen cree]

I work for 3 general surgeons. One of which is questioning modifier 25 versus 57. When the surgeons sees a surgical consult in the hospital ie. 99222, if a surgical procedure same day, is indicated, I use 99222-25. This surgeon feels that a modifier-57 should be used, not 25. Please help. Thankyou, KC

 

[ellzeycoding]

Modifier 57 is used on an E/M visit when that E/M visit leads to the decision to perform major surgery (a procedure with 90 postop days). <-- that's the difference

Modifier 25 us used on an E/M to indicate it is separate and identifiable from other billable minor procedures (codes with 0 or 10 postopdays)