Wiki Open Fractures

[debmorrison]

We are having a "discussion" as to whether we can bill an open fracture using the fracture code as well as an E&M visit for the open wound. We would append modifier -25 to the E&M.
I am wondering how others code out open fractures....
Thanks!!!
Debbie

 

[drsnpatil]

contributor

We are having a "discussion" as to whether we can bill an open fracture using the fracture code as well as an E&M visit for the open wound. We would append modifier -25 to the E&M.
I am wondering how others code out open fractures....
Thanks!!!
Debbie

I have one question regarding Mod. If selected surgery code for open fracture having 90-day global period then we need to append Mod-25 or 57 with E&M if its billable with surgery code?

 

[debmorrison]

We arent taking the patient to the OR, just treating a fracture with an open wound. I was wondering if we could bill an E&M code with the fracture code. We would "link" the E&M visit with the wound diagnosis.
Perhaps in this senario we could use both the -25 and -57????

 

[Bella Cullen]

We arent taking the patient to the OR, just treating a fracture with an open wound. I was wondering if we could bill an E&M code with the fracture code. We would "link" the E&M visit with the wound diagnosis.
Perhaps in this senario we could use both the -25 and -57????

No you would not use both modifiers.
If the procedure you are billing carries a 90 day global period then the E&M on the same day would get a 57 modifier.
If the procedure you are billing carries a 0 or 10 day global period then the E&M on the same day would get a 25 modifier.