Modifier -57, Decision for Surgery:

An Evaluation and Management service resulted in the initial decision to
perform surgery during the E/M encounter.

Let's describe this modifier:

An OB/GYN sees a patient who complains with severe abdominal pain. It turned
out (through ultra sound, radiology and all other diagnostic testing and
documentations), the patient is having an ectopic pregrancy. The OB/GYN
performs the laparoscopic surgery on the same day. The E/M encounter will
then be reported with modifier 57 which resulted to decision for surgery. The
laparoscopic surgery should also be reported as performed on the same day
without a modifier.

CPT codes and its descriptions are copyrights, owned, maintained and is a
trademark of the AMA (American Medical Association).
*** Always consult your CPT Code Book! and the NCCI Edits
*** Get more information on clinical guidelines and policies from your local CMS
carriers and from your third party payors
*** You can purchase CPT Code books and CPT Assistants issues from the
AMA's Bookstore!
When and
How Do I Use
Modifier -57?

What is
Modifier -57
there is NO excuse for Ignorance!