Reader Questions:
Modifiers 57/58 Describe Two Fracture Surgeries
Published on Sat Apr 24, 2010
Question: A patient presented to the emergency room and the podiatrist performed a closed reduction and manipulation for a trimalleolar ankle fracture. The closed reduction didn't work so the DPM returned to surgery to repair the fracture the next day. How should I code both surgeries?Montana SubscriberAnswer: You'll need to code for three services: the initial visit and examination the first surgery, and the second surgery.If the patient was treated in the emergency room, choose from 99283-99285 (Emergency department visit for the evaluation and management of a patient ...). If the patient was admitted to the hospital before the decision for surgery was made, instead report 99222 (Initial hospital care, per day, for the evaluation and management of a patient ...). Append modifier 57 (Decision for surgery) to the correct E/M code.For the original ankle repair, submit 27818 (Closed treatment of trimalleolar ankle fracture; with manipulation). Include modifier LT (Left [...]