Forum - Questions & Answers

Aug 17th, 2011 - dgarrett10

modifier 57

Can you bill medicare with a 99203 and a fracture code with no modifier for EM code I have always been paid for this without modifier but for a followup vist if patient presented with differnet problem used a modifier 24. I was told by a Medicare rep. years ago that for a new visit no modifier needed for new office visit.

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Aug 18th, 2011 -

re: modifier 57

Check patient history if the patient is in global then it is appropriate to add modifier 24 for the unrelated E&M service to the original procedure.

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Aug 18th, 2011 - DebraS   67 

re: modifier 57

We still use the modifers. -57 is for an E/M attached to a procedure with 90 day global. -24,-25 is 0-10 day global.

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Aug 18th, 2011 - jschmutz   323 

re: modifier 57

If you are reporting an E/M code with global fracture care code (ie 25500), then you would need to append a 25 or 57 modifier to the E/M code. Whether you use the 25 or 57 is a payer preference. Most prefer the 57. If you are getting paid without the modifier, then great. No harm done.

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