As long as you can support the usage of the 25 modifier you should be able to appeal and win. If the evaluation of the patient includes evaluation of other body areas for other possible injuries, then you have no problem. Remember you do not need 2 dx codes when you use the 25 modifier. Just the evaluation that is over above and beyond what is ordinarily required for the procedure. If the evaluation is only for the fracture then you do not have enough to support the E&M charge. The fracture repair code includes that the physician will evaluate the fracture area.
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