Wiki fracture care

[jsusanweaver@yahoo.com]

Does anyone know what the appropriate modifier would be when an outpatient has two different fractures at the initial visit? Both fractures would be coded for fracture care but without a modifier, could insurance co. decline one of them?

 

[HeidiLynn]

Why aren't you using a modifer? I would use a 51 for multiple procedures.

 

[mitchellde]

Does anyone know what the appropriate modifier would be when an outpatient has two different fractures at the initial visit? Both fractures would be coded for fracture care but without a modifier, could insurance co. decline one of them?

It just depends on the fractures on what body part. If you have an arm fracture and a leg fracture not only will the dx codes be different but so will the CPT codes so no need for a modifier.
If you hav say two leg fractures you might have a different dx code and you might not, so you can use the LT and RT modifiers for two different procedures say a closed reduction on the left side and an ORIF on the right side.
So it is all dependent on the scenario.