modifier 57

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.

Return to List of All Modifiers


Similar Posts

Leave a Reply

Your email address will not be published. Required fields are marked *