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Open Fractures

  1. Default Open Fractures
    Medical Coding Books
    We are having a "discussion" as to whether we can bill an open fracture using the fracture code as well as an E&M visit for the open wound. We would append modifier -25 to the E&M.
    I am wondering how others code out open fractures....
    Thanks!!!
    Debbie

  2. #2
    Default contributor
    Quote Originally Posted by debmorrison View Post
    We are having a "discussion" as to whether we can bill an open fracture using the fracture code as well as an E&M visit for the open wound. We would append modifier -25 to the E&M.
    I am wondering how others code out open fractures....
    Thanks!!!
    Debbie
    I have one question regarding Mod. If selected surgery code for open fracture having 90-day global period then we need to append Mod-25 or 57 with E&M if its billable with surgery code?
    Last edited by drspatil; 08-05-2010 at 10:58 AM. Reason: Spelling

  3. Default
    We arent taking the patient to the OR, just treating a fracture with an open wound. I was wondering if we could bill an E&M code with the fracture code. We would "link" the E&M visit with the wound diagnosis.
    Perhaps in this senario we could use both the -25 and -57????

  4. Default
    Quote Originally Posted by debmorrison View Post
    We arent taking the patient to the OR, just treating a fracture with an open wound. I was wondering if we could bill an E&M code with the fracture code. We would "link" the E&M visit with the wound diagnosis.
    Perhaps in this senario we could use both the -25 and -57????
    No you would not use both modifiers.
    If the procedure you are billing carries a 90 day global period then the E&M on the same day would get a 57 modifier.
    If the procedure you are billing carries a 0 or 10 day global period then the E&M on the same day would get a 25 modifier.

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