Wiki global fracture coding

[kpichon]

Question on whether or not the Orthopaedic provider should global fracture code. Pt was seen at an Urgent Care facility for a closed metatarsal fracture. Pt had x-rays done and was placed in a cam boot and then referred to Ortho. The Ortho doc didn't provide the restorative care but is managing the fracture and doing all of the follow up care. Is it appropriate for the Ortho doc to use a global fracture cpt code?

 

[Orthocoderpgu]

Question on whether or not the Orthopaedic provider should global fracture code. Pt was seen at an Urgent Care facility for a closed metatarsal fracture. Pt had x-rays done and was placed in a cam boot and then referred to Ortho. The Ortho doc didn't provide the restorative care but is managing the fracture and doing all of the follow up care. Is it appropriate for the Ortho doc to use a global fracture cpt code?

Look at modifiers -54 & -55.

 

[kpichon@dsmcapitalortho.com]

I did research those but we had never used a 55 before. Am I safe to assume mod 55 is appropriate for the ortho doc who didn't do the restorative care? thank you for your help!

 

[amyjph]

Here are some links to other discussions with info about it.

https://www.aapc.com/discuss/threads/fracture-care-debate.186660/?view=date#post-510678

I used an example just like the one you are talking about in this link:

https://www.aapc.com/discuss/threads/fx-care-help.184888/?view=date#post-506107

Searching the forums for topics is helpful a lot of times the questions have already been discussed and/or answered.