Modifier 57 in Medical Billing
Modifier 57 is used to indicate that an evaluation and management (E&M) service resulted in the decision to perform surgery.
Modifier 57 in Medical Billing Explained
In medical billing, modifier 57 is added to E&M codes when the physician’s decision to perform surgery was made during the initial evaluation. This modifier signals to the payer that the evaluation led to the surgery and should be reimbursed accordingly.
For example, a patient is seen in the emergency room, and the physician decides that immediate surgery is necessary. The E&M service is billed with modifier 57 to indicate that the evaluation led to surgery.
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