Modifier 57 relates to major surgical procedures. Using gained knowledge and the CPT manual, compare and contrast modifier 57 with modifier 25. How can these two modifiers be clearly identified and what are the significant differences between these two modifiers?

Question

What will be an ideal response?

Answer 1

Answers should include (but may not be limited to) the following:
Modifier 57 identifies a physician's decision for immediate major surgery on the same day or the day after the performed E/M service and should be appended to the E/M service to indicate that the decision for major surgery was made less than 24 hours before the actual surgery was performed. The very nature of this clinical situation precludes elective surgery, which can be scheduled at the convenience of the surgeon and the patient.
Modifier 25 has four specific criteria: Content of service must be documented for the E/M service and must support at least a problem-focused (or level 1) service; the E/M service must be performed for an identifiably different reason from that of the other service or procedure; the same physician must perform both services; the services must occur on the same day.