codegirl0422
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Hello Everyone,
We are having a discussion and I was to see what you guys think:
If a patient comes in with a known fracture (referred by their PCP, urgent care clinic or ER), would a new patient visit (or established) be billed with modifier 57 with the fracture cpt code? Even though the patient comes in with a known fracture, our doctors are still having to do the medical decision making on how to handle the fracture. And most of the time, the doctor has never seen the patient, so he is doing the necessary history and exam.
We are having a discussion and I was to see what you guys think:
If a patient comes in with a known fracture (referred by their PCP, urgent care clinic or ER), would a new patient visit (or established) be billed with modifier 57 with the fracture cpt code? Even though the patient comes in with a known fracture, our doctors are still having to do the medical decision making on how to handle the fracture. And most of the time, the doctor has never seen the patient, so he is doing the necessary history and exam.