ED Coding and Reimbursement Alert

Answer: No, you won’t need modifier RT (Right side) — but you will need another modifier in its place to complete this claim.

For this encounter, report:

• 26600 (Closed treatment of metacarpal fracture, single; without manipulation, each bone) for the fracture repair.
• Modifier F7 (Right hand, third digit) appended to 26600 to show the anatomical location of the injury.
• 99284 (Emergency department visit for the evaluation and management of a patient, which requires these 3 key components: A detailed history; A detailed examination; and Medical decision making of moderate complexity...) for the E/M.
• Modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service) appended to 99284 to show that a significant, separately identifiable E/M occurred before the fracture repair.

More about digit modifiers: In an effort to be as specific as possible, CPT® created finger and toe modifiers to specify which digit the provider treats during an encounter. These modifiers are more specific than lateral modifiers RT and LT (Left side), so use them whenever possible.

The digit modifiers are:

• FA (Left hand, thumb)
• F1 (Left hand, second digit)
• F2 (Left hand, third digit)
• F3 (Left hand, fourth digit)
• F4 (Left hand, fifth digit)
• F5 (Right hand, thumb)
• F6 (Right hand, second digit)
• F7 (Right hand, third digit)
• F8 (Right hand, fourth digit)
• F9 (Right hand, fifth digit)
• TA (Left foot, great toe)
• T1 (Left foot, second digit)
• T2 (Left foot, third digit)
• T3 (Left foot, fourth digit)
• T4 (Left foot, fifth digit)
• T5 (Right foot, great toe)
• T6 (Right foot, second digit)
• T7 (Right foot, third digit)
• T8 (Right foot, fourth digit)
• T9 (Right foot, fifth digit).