halebill
Guest
My physician performed a 28470 (closed treatment metatarsal fracture) and 11760 (repair nailbed) in the office. The 11760 = 6.21 RVU's and is a minor procedure with 10 day global. The 28470 = 6.03 RVU's and is a major procedure with 90 global.
1. Typically, we report the higher valued procedure as the primary procedure. Does anyone know of any rules which state the "major" procedure must be reported as primary, even if it has a lower RVU?
2. The physician also performed significant, separately identifiable evaluation & management in addition to the usual pre-operative care of the procedures, in which the decision for surgery was made. Would it be appropriate to append both modifiers 25-57?
1. Typically, we report the higher valued procedure as the primary procedure. Does anyone know of any rules which state the "major" procedure must be reported as primary, even if it has a lower RVU?
2. The physician also performed significant, separately identifiable evaluation & management in addition to the usual pre-operative care of the procedures, in which the decision for surgery was made. Would it be appropriate to append both modifiers 25-57?