Wiki Re fracture same site question

[Bella Cullen]

Hello,
Any answers will help on this.
Dr treated patient for a clavicle fracture, the fracture healed and is still in global. The patient re fractures same site after it was healed, still in global. Can dr bill for Office visits with 24 mod? Would you consider this a new injury or same?
Thanks,

Melissa, CPC

 

[bmaxwell3]

Melissa,

You have to have the documentation dead on because they will send a denial and it will have to be appealed. But if it is truely a new fracture and at the same site then you can bill for an office visit. Did they bill fracture care or office visits on the first fracture?

bridget

 

[Bella Cullen]

Melissa,

You have to have the documentation dead on because they will send a denial and it will have to be appealed. But if it is truely a new fracture and at the same site then you can bill for an office visit. Did they bill fracture care or office visits on the first fracture?

bridget

I billed fracture care so it is in global right now for that, and the doc just asked me if he can bill for an office visit since that fracture was healed and then the pt refractured it in the same spot.
So do you think that is considered a new injury? or post op?
thanks for your help.

 

[aprilroc]

This is most definitely a new injury. Bill with a 24 modifier with documentation. That should work.

 

[bmaxwell3]

You should be ok use the 24 and make sure the documentation states new injury and that the other fracture was healed at the time of the new injury and the date of injury would be helpful if an appeal is needed. Good luck!

Bridget

 

[Bella Cullen]

thanks for both of your answers, I will let the doctor know!!

 

[kjstearns]

I agree as well. You should be able to bill with a -24. Good luck!