It depends on if the patient comes in with a dx of fracture or not. If they have been to the emerency room and were diagnosed with a fracture then I would not use the 57 modifer for the first office visit because you already know that it will most likely need to be set.
However if the patient does not know it is borken and has not been to the ER then you should be able to use the 57 for the first office visit.
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