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  1. Melissa Posted 5 Year(s) agoRelated Topics

    My surgeons have been billing office E/M on the same day as surgery if they evaluate them in the offic then take to surgery. I have one that appends a 25 and one that appends a 57. They also see patients in OBS and as IP the day before or the day of surgery. They have been appendeding a 57. My billing company is telling them they can not do that. How else do they get paid for the evaluation and decision for surgery? Most of these patient are new patients.

  2. SuperCoder Posted 5 Year(s) ago

    Could you please let me know which procedure is billed with E/M? First you have to judge whether the decision of procedure performed is minor or major. Modifier -25 is basically used an E&M that resulted in a decision to perform a minor surgery, those having 0-day, 10-day, or no global period. On the other hand, modifier -57 is used with an E&M service that resulted in the initial decision to perform the major surgical procedure with a 90-day global period. Again modifier -57 is mostly used to report a major surgical procedure on the day of or the day before the surgery.

  3. Melissa Posted 5 Year(s) ago

    Some minor are done in office which I append a 25 in hospital setting 57. It looks as if I am doing it correctly. Thank you.

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  • Posted by 23843 Melissa, 5 Year(s) ago. There are 3 posts. The latest reply is from Melissa.