Fx with manipulation after nonmanipulative fx

kwendt

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5
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Sun Praire, WI
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Scenario: Patient came in with a proximal humerus fracture on first visit. Code 23600 was charged out for fx care. Patient came in 10 days later and the fracture had displaced. Manipulation of the fracture was then performed. I plan on using 23605 but don't know which modifier to attach to it (-76,-52 or -79?)? Thanks!
 

dpaige

Networker
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33
Location
Long Beach, CA
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I would use the -58 (staged procedure - same physician - during global) modifier. In the description of the modifer in the Coders Desk Reference it states it can be used when the procedure "is more extensive than the original procedure." In this case I think it qualifies for that modifier.
 
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