cpccoder2008 - in my opinion, (based on what you posted) -
"New patient seen in clinic for fracture, patient is to come back in 4 days for pre-op then surgery. Would i bill fracture care for this initial visit and the surgery with - 58 ? Or would i just bill the new patient visit or then the surgery without any modifier's ? Also if anyone can tell me where i can get this in writing also,, those doctor's don't like to be wrong lol, they need to see proof. Please someone help me ?"
First - Modifier 58 - is "staged or related procedure or service, etc" so I think you meant MODIFIER 57 - decision for surgery.
They only time you need to append the modifier 57 "decision for surgery is IF it office visit being charged falls within the "global period" of the surgery. It's so payment will still be made on the office visit, even though it's falling in a global of surgery, it's to get it out of the global. Since the surgery isn't going to be for at minimun 4 days later there isn't a need for modifier 57 on that office visit at all. you can just charge the procedure (fracture treatment or cast application whatever the case may be)
Also, you
can indeed charge for a preop visit UNLESS it is within the global period of the surgery. So if the preop visit is the day before (major surgery w/ 90 day global) or the day of the surgery (minor surgery)procedure, you can't charge for it UNLESS -it's the decision for surgery (which in your case it isn't). at which point you'd use the 57 decision for surgery modifier on the E/M for the preop.
you can find info pretty much anywhere, just google "global surgical package"...