Which modifier is added to an E/M service to indicate the initial decision to perform surgery?

The modifier that indicates the initial decision to perform surgery is 57. This modifier is specifically designed for Evaluation and Management (E/M) services that lead to a surgical procedure and is significant because it helps to denote that the E/M service was a key factor in the determination to proceed with surgery.

Using modifier 57 communicates to payers that the decision to undertake the surgical procedure was made during the patient encounter, making it important for correctly billing for that E/M service. It ensures appropriate reimbursement by clarifying that the visit was not just an ordinary follow-up but an integral part of the decision-making process for the surgical intervention.

Modifiers like 58 and 59 serve different purposes, with modifier 58 indicating a staged or related procedure during the postoperative period and modifier 59 designed to identify distinct procedural services. Therefore, while those modifiers have specific applications, they do not relate to the initial surgical decision-making process in the same manner as modifier 57.