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Fracture care

rdavies

Contributor
Messages
11
Location
Midland, MI
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0
I have a patient that had a X-ray confirmed broken arm. Provider selected an E & M and fracture care code. The fracture care code has a 90 day global. He told the patient to come back in 5 days for a recheck. At the recheck visit the arm was not healing right. The provider selected an E&M with mod 24/57. (decision for surgery) Is the recheck part of the global package?l
 

mitchellde

True Blue
Messages
13,505
Location
Columbia, MO
Best answers
2
Yes the recheck is a part of the global. Global includes visits for complications, you can charge for the additional surgery with a modifier but not the E&M. The 24 modifier indicates this is a different problem unrelated to the the original condition, which is not true in this case.
 

rdavies

Contributor
Messages
11
Location
Midland, MI
Best answers
0
Thank you for the confirmation. My thought process was the same. I don't know where to look for documentation to present to my superiors. Can you help?
 

mitchellde

True Blue
Messages
13,505
Location
Columbia, MO
Best answers
2
In the CPT book at the beginning of the surgical section and in the Medicare manual where they define the global service and what is included. They are slightly different and most payers go by Medicare. Aslo the definition of the 24 modifier which is in the Federal Register as well as in Appendix A of the AMA version of the CPT book.
 
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