Wiki Closed fracture care with ORIF on same day

[Emmalia]

A patient was seen in the ER by an orthopedist, diagnosed with a scapula fracture and a tib/fib fracture. The provider is billing for closed treatment without manipulation of a scapula fracture along with the ER visit. The patient had surgery later on in the day for an ORIF of the tib/fib fracture. What modifier would be used for the ORIF of the tib/fib fracture?

We seem to be a having a difference of opinion within my office about this scenario. Anyone's input would be greatly appreciated.

Thanks

 

[FTessaBartels]

Only on E/M

Other than the -57 modifier on your E/M service, you do not need any modifier.

Hope that helps.

F Tessa Bartels, CPC, CEMC

 

[Evelyn Kim]

Agree, unless you choose to add the RT/LT for the appropriate side of the body for the tib/fib fx.