2 fx on same limb: 1 or 2 90-day globals??

sfaltinson

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Provider saw pt in office in follow-up for radial fx. Upon exam (re-xray), provider also found a carpal fx on same limb. Wondering whether to code two 90-day global procedures for same treatment or one?

25500 Closed TX Radial Shaft Fx (813.42)
25630 Closed TX Carpal Fx (814.03)

Thanks,
Sara Faltinson, CPC
 

Bella Cullen

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Provider saw pt in office in follow-up for radial fx. Upon exam (re-xray), provider also found a carpal fx on same limb. Wondering whether to code two 90-day global procedures for same treatment or one?

25500 Closed TX Radial Shaft Fx (813.42)
25630 Closed TX Carpal Fx (814.03)

Thanks,
Sara Faltinson, CPC
Pt was already under global for the radial fx, correct? Then for this carpal fx you would code that as 25630-79(unrelated) because those are two different fractures. Even if it is the same limb it is still a different part of that arm. Also, you would still keep the first global and then start another 90 day global for the 25630.
So for example say 25500 global ends tomorrow, and the one for 25630 will end in 90 days. So if pt comes in for OV three days from now for 25500 follow up you can bill an OV, eg, 99213 with a 24 modifier because the carpal fx is the only one in global now.
Hope I explained clearly.
 
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