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fracture care /initial visit

Brenda Posted Tue 15th of June, 2010 20:25:41 PM

I have a new pt seen 99202 and pt has a fx. Can I bill the fracture care 28470-RT and the initial visit? My claim was denied stating visit is included in fx care which but pt was presented as a new pt so can capture the 99202 seperately? Is there a modifier I am missing?

SuperCoder Answered Wed 16th of June, 2010 05:56:05 AM

The insurance is correct in this case and also it is a general guideline that if a specific diagnostic treatment if billed with a office visit code then it is not paid separately, but if there are some other diagnosis apart from the fx then you can code an office visit with a 25 modifier.

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