Help with fracture care

peanutbutterkisses

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I have a patient who came in and has a metatarsal fracture. This is the read of the x-ray.

Transverse nondisplaced fracture through the base of 2nd, 3rd and 4th
metacarpals are identified. The alignment at the tarsals appears to
be maintained. Bony mineralization is appropriate.
The dr. placed her in a fiberglass splint with a consult to ortho.

I want to code
28450 - 54 -T1
28450 -54 - T2
28450 - 54-T3

Is this correct. The code says each fracture, but because it is a transverse fracture should I only code once? I do not code fx care often. Please advise.

Thanks
 

sgoodknight

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Hi there,

Fracture care can be a toughy!

Hey I'm assuming you meant to write metatarsal instead of metacarpal. The closed treatment of metarsals is 28470.

I see you are modifying with 54 which means surgical care only.

How is your doctor treating this fracture? It sounds to me that he/she is referring the patient to an ortho doctor for treatment. In that case your doctor should bill the appropriate E/M code (office, ER, etc.) related to diagnosing the fracture.

I also see you are using the "T" modifiers. T modifiers are used for the toes (phalanges)only not the metatarsals.

I hope this is helpful.

Have a great day!

Sandy
 

halebill

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Capital Coders, Columbia, SC
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I agree with sgoodknight in that, you should let the orthopedist bill for the fracture treatment. Typically, in this scenario, the referring physician should bill for the appropriate E/M, the splint application, and the fiberglass splint supplies.


Bill Hale, CPC
 
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