Wiki When to code for Global Fracture Care

[flogale2]

I had a general question.

When to code for Global fracture care?

I work for an Orthopedic physician and sometimes a patient will be seen initially in the ER for the fracture then referred to him for follow up care.

When the patient comes to see the orthopedic physician for the initial consult following the ER visit do I code for the global fracture care or just code for the E/M visit?

I am not sure if the ER physician would get to code for the global fracture care.

 

[ls0403]

You should find out if the ER physicians are billing for fracture care. If it's a manipulation, they could bill for fracture care with 54 mod but shouldn't be reimbursed for post-operative management component since they don't provide follow-up care. If they are billing and coding correctly with 54 mod, your provider could bill same code with 55 mod.

If the ER physicians are not billing for fracture care, your provider can bill global for whatever fracture care he provides.

Hope that helps.

 

[Thumper72]

When billing with the 55 modifier for the post op care, if the patient comes in for more then one Postop care, do you use the Fracture code with modifier 55 each time or do you bill a 99024 for future visits after the initial one that you bill the 55 on?

Thanks for any help.

 

[dclark7]

If you use the fracture care code with the 55 modifier you will be in the 90 day global period so any subsequent visits will be billed with 99024.