tci ED Coding & Reimbursement Alert - 2014 Issue 4

Reader Question: Remember Exceptions When Choosing Fracture Modifiers

Question:  A patient reports to the ED with an injured right finger he suffered during a basketball game. The physician diagnoses a closed metacarpal fracture, which he resets using manipulation and places in a plaster cast. The physician tells the patient to follow up with an orthopedist for continuing care. Notes indicate a level-four pre-procedure E/M service. Do I need to append a modifier to the E/M code? North Carolina Subscriber Answer:  Many insurers will want to see modifier 25 on the E/M. However Medicare, and a number of private payers, prefer modifier 57 each time the...

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.