How should I appropriately bill for an office visit where the physician evaluated the patient and it was decided that surgery was needed? What is the appropriate modifier to bill for this service?
If the office visit (evaluation and management (E&M) service) is on the day before a major surgery or on the day of a major surgery that result in the initial decision to perform the surgery are not included in the global surgery payment for the major surgery and, therefore, may be billed and paid separately. In addition, a provider would refer to the current procedural terminology (CPT) for the appropriate E&M code, and append the modifier 57 (Decision for Surgery) which would be used to identify that the office visit resulted in the initial decision to perform surgery.
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