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Mod 57 - (this was also put under medical billing)

Melanie Posted Mon 08th of February, 2010 17:49:23 PM

Patient was inpt-stay - had a GI consult. Patient was consulted and agreed to EGD/Dilation-via balloon procedure. Was also verified that this is a brand new Medicare patient for us....

99222
43249

Mod 57 - shouldnt that be going on 99222 ? To signify separate service - patient agreed to surgery?

TIA

SuperCoder Answered Tue 09th of February, 2010 15:52:56 PM

Yes. As that E&M service (for which you coded 99222) resulted in the decision-making for the Sx (43239) on the same day, you can append mod 57 to the 99222 code.

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