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abevan

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Please Help!!

I have a Dr who did a closed reduction on a phalanx in which I would charge fracture care on. He wants me to append a 54 modifier on the fracture care code as one of the other Dr in the office is going to follow patient through the global days. I am thinking that because they share a tax ID number that I can not append the modifier 54 because the same tac ID would be doing the follow up. Is my thinking correct???:confused:
Thanks
Amy
 
You are absolutely correct. As long as the providers are part of the same group and share the same tax ID, they would be considered the same provider. You would want to charge for the global fracture care.
 
Don’t append modifier -54, unless you want to have the whole claim denied by the carrier. You’ll spend more time and resources appealing it, at the end you’ll have to submit this claim without the modifier. ;)
 
I agree with Treetoad. In our office, the CFO determines who gets what portion internally for situations like this, based on the doctor attached to each visit.
 
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