Wiki Closed tx and open tx

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mlburnett

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I need some clarification on something. Say an ortho is consulted on call for a pt in the ER for a fracture of the distal radius and performs closed tx with manipulation. In the dictation he states that the pt will need open tx of that fracture. So the pt is told to follow-up in the office two days later to schedule the open procedure. The open tx is scheduled four days after the initial visit in ER. Can he charge for both the closed tx w/ manp. and the open tx? Please help me clarify my confusion. :confused:
 
Absolutely, he did the work and you will need to use your modifiers to help get it paid. The open procedure is considered a staged procedure and the global period will just restart the day before the ORIF is performed per Medicare rules and the day of service for payers that don't follow Medicare rules.

You could not charge for an E&M service for Medicare payers for the decision in the office to perform the ORIF, it is included into the closed manipulation code.
 
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