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Wiki Fracture

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baran

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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?
 
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
 
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