Patient fractured 5th right metacarpal 3/14/08, has 90 day global. On 5/7/08 patient re-fractured same metacarpal. How would this fracture charge be billed as it is in the global period from first fx? The OV notes say that the pt re-broke the old fracture and patient was placed in a short arm cast. Would this new fracture be inclusive, as global, to the original fx or can we bill a fx charge with a 76 modifier?