Wiki only use -57 when surgery is next day?

[Orthocoderpgu]

I'm coding a visit where the patient has decided to have surgery. It does not state that the surgery will be the next day or two. Does is matter if I use -57 if the surgery is more than a day or two away? How does your clinic handle something like this? Thanks.

 

[nyyankees]

I'm coding a visit where the patient has decided to have surgery. It does not state that the surgery will be the next day or two. Does is matter if I use -57 if the surgery is more than a day or two away? How does your clinic handle something like this? Thanks.

We only apply if it is day of or day before..

 

[doodiebuggy]

When I coded ortho (I year ago) we were always taught according to AAOS and KZA that when the visit was performed and the decision for surgery was made at that visit to add the 57 at that time because that is when the decision to perform surgery was made. The problem with that and the reason why most offices don't do it that way is because all the other visits leading up to the surgery will not be paid if for the same problem because the decision was already made. However, if you are ever audited and it is discovered that the decision was made and surgery wasn't performed for another week or so, all the other visits that may have been billed and the -57 added to the last one before surgery will be recouped.

 

[KMCFADYEN]

I code for ortho. We only append modifier 57 for decision for surgery if it is the day of or the day before the procedure.