tci ED Coding & Reimbursement Alert - 2001 Issue 3

You Be the Coder: Modifier -54 and Fracture Care

Question: We are considering billing fracture care with a modifier -54 (surgical care only) to show that the physician is only doing the initial care and referring the patient to an orthopedist for follow up. Will adding modifier -54 be the best way to appropriately optimize reimbursement?Florida SubscriberTest your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.Answer: You get 79 percent of the total Medicare Fee Schedule reimbursement if you use the -54 modifier with the surgery/musculoskeletal series 20000 codes and 81 percent for the surgery/integumentary 10000...

To read the full article, sign in and subscribe to tci ED Coding & Reimbursement Alert.

Thank you for choosing Find-A-Code, please Sign In to remove ads.