I am reaching here but I believe that since the ED doc did the manipulation, he/she can bill 27810-54. Obviously, once the patient is admitted to the Orthopaedic service, that particular code will not be utilized again as long as the manipulation resulted in a good reduction of the fracture. In the event the patient goes on to have open surgery, an entirely different code will be used. By appending the -54 modifier, you are telling the insurance carrier that your ED doc performed ONLY the surgical portion (even though no actual surgery was performed, care of fractures is considered in the surgery section).
Hope this helps.
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