If you performed a fracture repair or a dislocation repair and the patient returns within the global period and the medical condition is related to the original fracture or dislocation, you cannot charge for the visit. This would be a 99024 visit.
If the medical condition for the visit is NOT related to the original medical condition, then you CAN submit a 9928X. You need to submit a copy of the record to show that the current visit has no relation to the original fracture or dislocation.
If the patient came to the ED with a fracture or dislocation and you performed the repair in the ED, and the fracture or dislocation is the only medical condition, you can only charge for the repair and you use modifier 54. You cannot use modifier 57 (Decision for Surgery) to try and justify an ED E/M and a repair procedure when you have nothing to show that the ED code is significant and separate. The repair is a surgical procedure that supports itself without an E/M. Trying to bill...
If the medical condition for the visit is NOT related to the original medical condition, then you CAN submit a 9928X. You need to submit a copy of the record to show that the current visit has no relation to the original fracture or dislocation.
If the patient came to the ED with a fracture or dislocation and you performed the repair in the ED, and the fracture or dislocation is the only medical condition, you can only charge for the repair and you use modifier 54. You cannot use modifier 57 (Decision for Surgery) to try and justify an ED E/M and a repair procedure when you have nothing to show that the ED code is significant and separate. The repair is a surgical procedure that supports itself without an E/M. Trying to bill...
