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Wiki Wound and fracture on the same finger

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miugu

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Peetri, Harju
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Hi!

Does anyone know how to bill wound and fracture on the same finger during the same visit? It is not considered an open fracture because the wound is not communicating with the fracture. Is the wound care bundled into the fracture care and will not be paid or are we entitled to get paid for both? I feel we should get paid for both since the wound closure is a significant procedure.

The codes are:

12002
26750-54

Thank you!
 
If the documentation supports 2 distinctly separate services and they do not bundle then the repair of the wound is not included with the fracture care. They are not the same, even though you may be at the same anatomical area. Not all fractures have a wound closure, this would be atypical.

My question to you is why is the closed fracture, without manipulation with a modifier-54 being used? If your provider is an Emergency physician, I would only code the splint as they are only stabilizing a non-surgical fracture. But I would defer to your facilities policy on this matter.
 
Thank you for the answer. All definitive fracture care can be billed using fracture care codes. If the fracture care is non-definitive, splint codes should be used instead. If the patient is referred to an orthopedist, mod 54 is added to the fx care code.
 
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