What is modifier 57?

Modifier 57 is a billing and coding modifier used to indicate that a major surgical procedure was expected to be followed by a postoperative evaluation or management service during the global surgical period. This means that the decision for surgery was made during the global surgical period for the same condition or a related condition.

The global surgical period is typically defined as a certain number of days before and after a surgical procedure during which preoperative and postoperative services are included in the payment for the surgery. By using modifier 57, healthcare providers can ensure that they are compensated for the additional evaluation or management services provided during the global period.

It is important to note that the use of modifier 57 should be supported by documentation in the patient's medical record to justify the decision for surgery during the global period. Improper use of this modifier can result in denied claims or audits by insurance payers. Healthcare providers should familiarize themselves with the guidelines for using modifier 57 and ensure that they are appropriately documenting and billing for their services.