robbin carrone
New
I have a general question regarding coding/billing for fracture care.
The physicians are billing for fracture treatment, either with or without manipulation on the first visit. This is for either office or if they are called into the ER. They will then either schedule an open reduction the following day or so, and again, bill the open treatment, or refer the patient to another physician in the practice with a different subspecialty for a consult and another fracture treatment charge (either closed or open). All physicians are under the same Tax ID number. So in essence, they are billing for two fracture treatments for one fracture. I've also seen a physician try two different diagnosis codes for the same fracture, one for the closed treatment and the second for the open treatment the next day.
Can this be done? What modifier would be used for the second procedure? They do this for all insurances across the board, including Medicare.
I appreciate any feedback on this matter.
The physicians are billing for fracture treatment, either with or without manipulation on the first visit. This is for either office or if they are called into the ER. They will then either schedule an open reduction the following day or so, and again, bill the open treatment, or refer the patient to another physician in the practice with a different subspecialty for a consult and another fracture treatment charge (either closed or open). All physicians are under the same Tax ID number. So in essence, they are billing for two fracture treatments for one fracture. I've also seen a physician try two different diagnosis codes for the same fracture, one for the closed treatment and the second for the open treatment the next day.
Can this be done? What modifier would be used for the second procedure? They do this for all insurances across the board, including Medicare.
I appreciate any feedback on this matter.