tci ED Coding & Reimbursement Alert - 2019 Issue 1

You Be the Coder: Get A Handle on Modifiers

Question: Our ED physician attempted to reduce a fracture of the left hip, but was unable to do so. He used conscious sedation for the procedure. We’re planning to report 27265, 99285 and 99152, but we aren’t sure if any modifiers are necessary. Can you advise? Supercoder.com Subscriber Answer: In this situation, you would report the following codes and modifiers on your claim: 99285-57 (Emergency department visit for the evaluation and management of a patient,… Decision for surgery) 27265-52-LT (Closed treatment of post hip arthroplasty dislocation; without anesthesia,… Reduced services, Left side) 99152 (Moderate...

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