tci Part B Insider - 2017 Issue 12

E/M Coding: Know These E/M Rules to Avoid Fracture Care Fails

Hint: Review E/M modifier usage and append if necessary. When you provide fracture care for a patient, you will very likely perform a separate E/M prior to the fracture care. How this separate E/M is reported depends entirely on the payer, however. Check out what the pros have to say about how to separately code an E/M service and fracture care on your claims. Observe Payer Specificities on Fracture Care E/Ms For most E/M services that result in fracture care with a 90-day global period, you should use modifier 57 (Decision for surgery) on the E/M code, says Dawn...

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