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28510 vs consult code

  1. #1
    Default 28510 vs consult code
    Medical Coding Books
    Patient was seen in Urgent care and thats where the patient had his t4 toe buddy taped. Specialty Physician billed 28510 and no new taping was done. The physician did perform xray and billed for that but the specialist wants to bill 28510 but he didn't perform/touch the patients toes. Should the physician bill 28510 or should he just bill the consult level codes (E/M section)??

  2. #2
    The specialist is allowed to bill for the fracture treatment 28510 even though he did not manipulate/touch the patient. Just remember all follow-up visits are included in the surgical code and is not separately reimburseable outside. You will be able to bill for any supplies or xrays during the post op period.

    also remember that the initial cast or splint is included in the fracture treatment therefore is not reimburseable even if it's provided after the day the fracture treatment was billed.

    all others casts/splints may require modifier -58 (staged/planned procedure during the post op period) when appropriate.

    I hope this helps. Some payers allow for the reimbursement of a consult/EM with modifier -57 if appropriate.

    I hope this helps!!!!

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