Wiki Fracture

[baran]

If a pt is seen in the ER for a closed fractured clavicle without manipulation & then comes to the pedi office(not affiliated) for several visits of follow up care instead of going to an orthopedist, can the pediatrician code a 23500 once even though the hospital may have also used the code & the pt wasn't seen in the office initially?

 

[FTessaBartels]

Mod 54 and Mod 55

You will need to know exactly how the ER physician billed.

The ER physician SHOULD have used Mod 54 on the fracture care, to signify s/he would NOT be providing postoperative care.

THEN, your physician will use the SAME fracture care code with a -55 modifier to show that you are providing the postoperative care.

Hope that helps.

F Tessa Bartels, CPC, CEMC