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2nd request Fracture Care Help

  1. #1
    Default 2nd request Fracture Care Help
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    Can anyone help me on this? I need some guidance. My doc saw a pt for a tibial plateau fx, billed a fx care code. Pt came in for global office visit, we did another xray and he found that he also has a femoral condylar fracture also that was missed the first time. He wants to charge another fx care code for the new discovered fx. Can I do this since it is related to the 1st fracture?

  2. #2
    I would say yes. It is a different fracture on a different bone. I would use "79" mod, the definition of 79 says it was unrelated to the original procedure. I am assuming the code you charged for the tib plateau fx said nothing about the femur???

    It depends on what codes you are charging- to make sure they are not included with each other.

  3. #3
    I know I'm stretching here but just trying to fully understand and do this right, the fx is related to the first fracture it just did not show up on the xray, but showed up later on the mri, so it happened at the same time of the intial injury, any thoughts?

  4. #4
    I was going off of the definition of the "79" modifer in the cpt book.

    It doesn't unrelated to the "injury" it says unrelated to the "procdure" done.

    I hope that helps

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