Wiki Closed Treatment + ORIF

[nyyankees]

I just received a couple of surgeries where the Dr performed a closed treatment of a fracture in the ER and in the same day admitted the pt and performed an ORIF. He using a 58 modifier on the ORIF - which I understand. My question is I think the insurance company will deny the claim based on the premise of why 2 in day? Has anyone had their Dr perform a multiple same day surgery like this scenario and how did the insurance company react?
Thanks..

 

[CrysLednum]

I have this situation frequently. When my docs are called in the ER the scenario is usually they do a closed reduction then admit with a decision for surgery (ORIF). I have been getting paid for both procedures. Good luck!

 

[nyyankees]

Thanks Cyrstal!!