Wiki Fracture Care CPT 27822 question

[Borlickd]

I have an Orthopedic provider (Doc 1) that performed CPT 27822 Open RX Trimalleolar FX in the hospital. Patient was discharged and seen a different Orthopedic provider (Doc 2) who wants to bill the same CPT with modifier 55.

I have tried to research this scenerio and couldn't find anything. If anyone has some insight, I would greatly appreciate it.

I'm thinking Doc 2 can't bill that, only 99024


Thank You,
Danielle, CPC

 

[spescetelli]

Are both Docs in the same practice?

 

[OCD_coder]

I agree with you both, if both providers are in the same practice Doc #2 will only be able to bill a postop care code 99024.

If Doc #2 is not with the same practice, a formal (written) transfer of care will need to occur before the mod-55 could be used. Carriers will deny Doc #2 if the global code was billed for Doc #1.