Modifier -25 is "significant, separately identifiable evaluation and management (E&M) by the same physician on the same day of the procedure." It is E&M that resulted in a decision to perform a minor surgery.

Modifier -57 is "decision for surgery. (It is) an E&M service that resulted in the initial decision to perform the surgery. This modifier is used to report an E&M service that resulted in a decision to perform a major surgical procedure on the day of or the day before the surgery."

Source: Medicare Part B newsletter # 01-020 , dated Sept.1, 2001, page 15.  ( PDF )

Medicare Part B Newsletter Index  is a compilation of all Texas Medicare newsletters published since Jan. 1, 1995. Articles are indexed by CPT code as well as by topic. When you subscribe, you receive a hard copy of the index and a disk (Word document), and updates are provided to you on disk.

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