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Re fracture same site question

  1. Exclamation Re fracture same site question
    Medical Coding Books
    Hello,
    Any answers will help on this.
    Dr treated patient for a clavicle fracture, the fracture healed and is still in global. The patient re fractures same site after it was healed, still in global. Can dr bill for Office visits with 24 mod? Would you consider this a new injury or same?
    Thanks,

    Melissa, CPC

  2. #2
    Default
    Melissa,

    You have to have the documentation dead on because they will send a denial and it will have to be appealed. But if it is truely a new fracture and at the same site then you can bill for an office visit. Did they bill fracture care or office visits on the first fracture?

    bridget

  3. Default
    Quote Originally Posted by bmaxwell3 View Post
    Melissa,

    You have to have the documentation dead on because they will send a denial and it will have to be appealed. But if it is truely a new fracture and at the same site then you can bill for an office visit. Did they bill fracture care or office visits on the first fracture?

    bridget
    I billed fracture care so it is in global right now for that, and the doc just asked me if he can bill for an office visit since that fracture was healed and then the pt refractured it in the same spot.
    So do you think that is considered a new injury? or post op?
    thanks for your help.

  4. #4
    Default
    This is most definitely a new injury. Bill with a 24 modifier with documentation. That should work.

  5. #5
    Default
    You should be ok use the 24 and make sure the documentation states new injury and that the other fracture was healed at the time of the new injury and the date of injury would be helpful if an appeal is needed. Good luck!

    Bridget

  6. Default
    thanks for both of your answers, I will let the doctor know!!

  7. #7
    Location
    Seattle First Hill
    Posts
    126
    Default
    I agree as well. You should be able to bill with a -24. Good luck!

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