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Thread: dislocations handled like fractures?

  1. #1
    Join Date
    Apr 2007

    Question dislocations handled like fractures?

    AAPC: Back to School
    When a patient has a fracture, we will treat it and refer to an orthopedist. We will only bill the office visit since we are not following the fracture. My question is when a patient has a dislocation reduced without a fracture and was referred out to the ortho for follow up, do we bill the same way as the fracture or do we bill the dislocation reduction code. I'm confused as both the fracture and dislocation codes have a 90-day global period (per my CPT book).

    Any help would be greatly appreciated.

  2. #2
    Join Date
    Apr 2007
    Milwaukee WI

    Default -54 modifier

    If you are performing the procedure (treatment of dislocation) but will be transfering "post-op" care to the ortho specialist, you should use a -54 modifier on YOUR procedure code. The orthopeaedist would use the same procedure code with a -55 modifier to signify the postoperative care.

    Don't let the work "operative" scare you. Any CPT code from 10000 through 69999 is considered a procedure / operation.

    Hope that helps.

    F Tessa Bartels CPC, CEMC

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