New vs. Established Patient

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June 23, 2016

Question:
If I see a new patient and during that visit I identify the need for surgery the same day, should I append a Modifier 57 to the E/M service?

Answer:
Yes, if you determine during the evaluation that the patient needs a major procedure (90 day postop global period) the same or next day, then it is appropriate to append Modifier 57 to the E/M code. 

*This response is based on the best information available as of 06/23/16.