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fracture care

  1. Default fracture care
    Medical Coding Books
    Does anyone know what the appropriate modifier would be when an outpatient has two different fractures at the initial visit? Both fractures would be coded for fracture care but without a modifier, could insurance co. decline one of them?

  2. #2
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    Why aren't you using a modifer? I would use a 51 for multiple procedures.

  3. #3
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    Quote Originally Posted by jbeano21@verizon.net View Post
    Does anyone know what the appropriate modifier would be when an outpatient has two different fractures at the initial visit? Both fractures would be coded for fracture care but without a modifier, could insurance co. decline one of them?
    It just depends on the fractures on what body part. If you have an arm fracture and a leg fracture not only will the dx codes be different but so will the CPT codes so no need for a modifier.
    If you hav say two leg fractures you might have a different dx code and you might not, so you can use the LT and RT modifiers for two different procedures say a closed reduction on the left side and an ORIF on the right side.
    So it is all dependent on the scenario.

    Debra A. Mitchell, MSPH, CPC-H

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