Wiki Fracture care and wound

[miugu]

What's the correct way to bill wound care and closed fx care on the same finger during the same visit? Is wound included in the fx care if it's not communicating with the fracture or can wound care be billed separately with modifier 59?

I would bill it like this:

99214-57
26750-54
12001-59

Thank you
M.

 

[mitchellde]

why are you using the 54 on the fx care and then not on the suture code? yes you can bill for both link your dx codes carefully.

 

[miugu]

I have never used modifier 54 on a wound care code, only on fx care codes. i never knew it can be used for wound care.

 

[miugu]

I don't think modifier 54 is required on the wound care code since the patient came back to us to remove the sutures.

 

[mitchellde]

well the 54 states you are providing the procedure only and none of the follow up. Why do you use it on the fx care? It is used on any code that has a global, and lac repair has a global with most carriers, some do not.

 

[miugu]

I'm using it on a fx care because patients are often sent to orthopedics afterwards. With wound care they return to us.

12001 does not even have a global period.

 

[miugu]

Simple wound closure never has global period. Only intermediate and complex repair has global period.