Forum - Questions & Answers

May 24th, 2011 - breathe3

25 vs 57 modifier

Our office has always used the 25 modifier when our Ortho performs fx care on the same day as a visit (pt came in with "wrist pain" and was found to have a fx of the radius after x-rays were taken). Now some coders are questioning whether or not this is appropriate because there is a 90 global period. Should they be appending the 57 modifier instead? I still believe it should be a 25 because it's performed immediately at the time of the visit.

Any feedback is appreciated.


Dawn K

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May 24th, 2011 - rphelps 615  1 

re: 25 vs 57 modifier

A procedure with a 90 day post op is considered major surgery. Modifier 25 applies when a minor procedure is done.

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May 25th, 2011 - jschmutz   323 

re: 25 vs 57 modifier

This is payer specific but in my experience most payers prefer the 57 modifier since fracture care has a 90 day global.

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