Scenario: A new patient presents to the office suffering from an injured left ankle she hurt while shoveling snow. The orthopedist carries out a detailed history and examination. Thinking it to be a fracture, the orthopedist orders a two-view ankle x-ray, which shows a bimalleolar fracture. The NPP provides local anesthesia and the surgeon uses closed treatment to manipulate the fracture. In order to ensure proper alignment, the orthopedist orders a second two-view ankle x-ray. Notes point to moderate medical decision making. The orthopedist writes the proper prescriptions, the NPP casts the ankle and the patient goes home. So in this scenario, can I code both ankle x-rays?
Well, since the orthopedist orders separate x-rays for different purposes (identifying the fracture, ensuring proper bone placement), you can code for both. You should report the following on the claim:
27810 (Closed treatment of bimalleolar ankle fracture [example, lateral & medial malleoli; or lateral & posterior malleoli or medial & posterior malleoli]; with manipulation) for the fracture care
Well, since the orthopedist orders separate x-rays for different purposes (identifying the fracture, ensuring proper bone placement), you can code for both. You should report the following on the claim:
27810 (Closed treatment of bimalleolar ankle fracture [example, lateral & medial malleoli; or lateral & posterior malleoli or medial & posterior malleoli]; with manipulation) for the fracture care
E016.0 (Activities involving property and land maintenance, building and construction; digging, shoveling and raking) added to 27810, 99204 and 73600 to represent the cause of the patient’s ankle fracture.
See to it that you check with your payer update prior to filling this claim. Some payers might require you to place a modifier such as 51 (Multiple procedures) or 59 (Distinct procedural service) to the second x-ray code.
For more on this and for other medical coding updates, sign up for a one-stop medical coding guide like Supercoder.com
See to it that you check with your payer update prior to filling this claim. Some payers might require you to place a modifier such as 51 (Multiple procedures) or 59 (Distinct procedural service) to the second x-ray code.
For more on this and for other medical coding updates, sign up for a one-stop medical coding guide like Supercoder.com
