Closed Fracture Care and Open Fracture Care

[kathy a]

Our physician saw a patient in the ER for a bi-malleollar fracture of the ankle. He casted her while in the ER and did take X-rays. He decided to admit the patient and to do an ORIF of the ankle the next day. Would I be able to charge the Admission-# 99222-25 with #27810-RT, and the Xray #73610-26, RT and then also charge # 27814-58-RT with fluoroscopy # 76000-26 for the next day? I'm not sure if I can bill both, since they were on different days? Thanks

[risnerclan]

if he did not manipulate the fracture no you would not charge 27810, sounds like he just casted the patient until he could operate the following day.

[maryanneheath]

Originally Posted by kathy a

Our physician saw a patient in the ER for a bi-malleollar fracture of the ankle. He casted her while in the ER and did take X-rays. He decided to admit the patient and to do an ORIF of the ankle the next day. Would I be able to charge the Admission-# 99222-25 with #27810-RT, and the Xray #73610-26, RT and then also charge # 27814-58-RT with fluoroscopy # 76000-26 for the next day? I'm not sure if I can bill both, since they were on different days? Thanks

Actually, I believe you could bill 27808, closed tx of bimalleolar ankle fracture, no E/M code, a 57 modifier on the 27808, and then the next day the 27814. Of course, this is as long as the documentation supports it. Basically, for the first day you can EITHER go with an E/M and cast application OR fracture care, depending upon the documenation and which way your orthopod wants to bill.

Thanx,
MaryAnne

[Donna T]

I don't believe you can append a -57 modifier to code 27808. I do agree though that for the ER you'd either do the E/M (with a -57 modifier), cast application and xray or the fracture care and xray. Hope this is helpful!

[campy1961]

Donna is correct you can either the E/M with other services or the fracture code.

[maryanneheath]

You're right Donna, no mod 57 on the procedure code, LOL!!!!!

[mousehouse1]

Do your ER visit w 57 modifier and charge the ORIF for the nex day