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Well, let me give it a try.....Major surgery includes: All preoperative visits (in or out of the hospital) by the surgeon beginning the day before surgery. So if the patient was seen 2 days before surgery, then you could bill an E&M. If the patient was seen the day of or day before surgery and that is when the decision for surgery was made, then the -57 modifier applies (decision for surgery). Otherwise, if the surgery was planned, say a week in advance, the patient comes in for preop 2 days before the surgery, you can charge an E&M, if seen 1 day before surgery, you cannot charge an E&M unless the above modifier rule above applies. Hope didn't make this too complicated. Anyone else have a simpler way of explaining....
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