Wiki New injury during global, with cast change for fracture during global

[aimes]

I have two different scenarios:

1.) Patient has a fracture of the right foot and is in global. Patient comes in during global for a sprain of the left wrist. While at the visit for the left wrist, patient gets a re-cast for the right foot.
How should this be billed out so that the re-casting is not getting denied global to the E&M? We have received a few denials.
We billed:
E&M w/mod 24 dx for wrist linked
Cast app w/mod 58 dx for fracture linked

2.) Also, if there was an E&M with a new problem during global (wrist sprain), and the new problem gets casted or splinted as well as the fracture that is in global gets re-casted, which mods would be correct?

We billed:
E&M w/mod 24 with dx for new issue
Cast app w/mod 58 with dx for global fracture linked
Cast or splint app w/mod 79 with dx for new problem linked.

 

[iowagirl77]

The modifiers you have so far are correct, but you need more. You are missing modifier 25 on the E/M to indicate the visit is separately supported from the cast/splint done that day. Also, if 2 cast/splints were applied you would also need a 51 modifier for the second.

 

[aimes]

Thank you so much!