What do you do?

primrose1

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Just wondering how you may do things in this scenario:

Patient comes into the office with a bimalleolar fracture. Is treated with a cast/splint the first day but is being scheduled to go to the OR the following week (5-6 days after the office visit) for an ORIF.

Do you code the initial office visit with a fx charge and when the ORIF is completed add modifier 58 as a staged procedure, or do you just do an E/M and casting with the first office visit and not charge the fx charge knowing the patient will be going to the OR?

Kris
 

JMeggett

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Spokane Valley, WA
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Just wondering how you may do things in this scenario:

Patient comes into the office with a bimalleolar fracture. Is treated with a cast/splint the first day but is being scheduled to go to the OR the following week (5-6 days after the office visit) for an ORIF.

Do you code the initial office visit with a fx charge and when the ORIF is completed add modifier 58 as a staged procedure, or do you just do an E/M and casting with the first office visit and not charge the fx charge knowing the patient will be going to the OR?

Kris
I would code your 1st scenario, Fx care in office and then modifier -58 on the ORIF.

Jenna
 

primrose1

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Thanks for the reply!! Is there a time limit between the first office visit and going to the OR where it's acceptable to do the staged coding?
 

MMadrigal

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Just wondering how you may do things in this scenario:

Patient comes into the office with a bimalleolar fracture. Is treated with a cast/splint the first day but is being scheduled to go to the OR the following week (5-6 days after the office visit) for an ORIF.

Do you code the initial office visit with a fx charge and when the ORIF is completed add modifier 58 as a staged procedure, or do you just do an E/M and casting with the first office visit and not charge the fx charge knowing the patient will be going to the OR?

Kris
Kris, knowing the pt is going to surgery, I would code the E&M with mod-25, a Short Leg Cast, and materials only. Mary
 
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