On the day before a major surgery with a 90-day global, the surgeon’s E/M visit includes the decision that surgery is indicated. Which modifier best protects that decision-for-surgery E/M from global package bundling?
Select an answer to reveal the explanation.
Short Explanation
Decision for major surgery on that E/M—often the day before—gets modifier 57 so the visit isn’t swallowed by the global package. Think ‘green light for the operation,’ not a routine vitals stop.
Full Explanation
Modifier 57 indicates an E/M service that resulted in the initial decision to perform surgery, typically used with major procedures (commonly 90-day globals) on the day before or day of surgery per payer rules so the E/M is not bundled into the global package. Modifier 25 is the usual tool for significant E/M with minor procedures; 24 and 78 address unrelated postoperative E/M and related return-to-OR surgery, respectively.