what does "each" indicate on 28475?

codeforever

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If there are 2 metatarsal fractures and one manipulation, I'm not sure what "each" means on code. Do I need to add modifier or something?

Thanks
 

Donna T

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"Each" would mean each metatarsal. So if there were 2 MT fx's and only one required a manipulation then you'd bill a 28475 (with manipulation) and a 28470 (without manipulation) along with the correct modifiers to signify which toes were fractured.
 

scooter1

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That would be each metatarsal.
In some cases you would have more than one metatarsal that is fractured.
 
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Metatarsal Fracture

Metatarsal Fractures I don't think are coded with the "Toe" modifiers. Those modifiers would be used on a Fracture of the Phalanx [toe] such as 28510 or 28515 if manipulated.

I use units for metatarsal fractures and add a comment note to the claim form on which metatarsals are fractured, 1st, 2nd, etc.

Would like to hear from other ortho billers on this scenario.

Thanks,
Cw
 

Donna T

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MT fractures

Metatarsal Fractures I don't think are coded with the "Toe" modifiers. Those modifiers would be used on a Fracture of the Phalanx [toe] such as 28510 or 28515 if manipulated.

I use units for metatarsal fractures and add a comment note to the claim form on which metatarsals are fractured, 1st, 2nd, etc.

Would like to hear from other ortho billers on this scenario.

Thanks,
Cw
I just wanted to clarify that I was being generic by saying toes. I was not stating that a "T" modifier needed to be used. I agree with your comment otherwise. The toe is defined as the area between the distal to the mid metatarsal-phalangeal joint so if the fracture falls within those areas then a "T" modifier would be appropriate. :p
 
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Metatarsal Fractures

I thank you for responding. I learn something new every day and actually like getting these "second opinions".

Have a great day!

CW
 
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