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Modifier 57 Decision for Surgery


CPT modifier 57 is used when the initial decision to perform a major surgical procedure is made during an E&M service provided the day before or the day of a major surgery. Modifier -57 replaces HCPCS Level II modifier QI (decision for major surgery). Modifier -57 should be used only in cases when the decision for surgery was made during the preoperative period, the day before or the day, of a major surgical procedure (procedures with 90 days of follow-up).

Modifier 57 should not be used with E/M visits furnished during the preoperative period of minor procedures (0-day or 10-day follow-up period). Use Modifier -25 to report a significant, separately identifiable E/M service by the same physician on the day of a procedure.


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