You would NOT bill an E&M with closed fracture care, without manipulation. The only time you could bill an E&M with a fracture code is when you do surgery or when you do closed manipulation. If you do not manipulate the fracture or do surgery, there is no E&M attached. Example: 25600 (no E&M). 25605 (E&M with 57 modifier).
Thank you for your input! Do you work for a large ortho group?
Armen, are you appending any modifier to the E/M? Thanks so much, Mary
I know this is probably late but mod 57 is only used when a 'decision for surgery' is determeined. You can only use this mod a couple of days before as an OP setting or the day of surgery if IP.
You would not put a 57 modifier on an office visit if fracture care was initiated prior to the first office visit. We start fracture care on patients all the time in the ER.