tci ED Coding & Reimbursement Alert - 2013 Issue 11

Reader Question: The Unexpected Return Of A Referred Patient Can Cause Global Problems

Question: We have concerns about how to report a follow up visit to a patient that was seen by one of our ED physicians for fracture care, which we reported with a 54 modifier because he was referred for follow up with an orthopedist for the remainder of the global period. When he showed back up in our ED for part of the follow up care, should we then append a 55 modifier to capture the services provided? Ohio Subscriber Answer:  If you did not realistically expect the patient to return for follow up care included in the...

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