Modifier 57: Decision for Surgery

June 9, 2016

I saw a patient on a Friday and scheduled elective surgery for the following Monday. Do I need a 57 modifier on the E/M code I did on Friday?

Modifier 57 is required on an E/M code that is the decision for surgery visit if the visit occurs the day before or the day of a major procedure, meaning a procedure with a 90-day postoperative global period. When the decision making E/M service occurs outside of that range (day before or day of a major procedure) then modifier 57 is not necessary.

*This response is based on the best information available as of 06/09/16.

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