tci ED Coding & Reimbursement Alert - 2023 Issue Q1

Reader Question: Code Order Matters for Optimal Claims

Question: The ED physician performed closed treatment of a metacarpal fracture without manipulation on a patient’s left second digit and closed treatment of a metacarpal fracture with manipulation on a patient’s third left digit. How should I report this encounter? Illinois Subscriber Answer: On your claim, report: 26605 (Closed treatment of metacarpal fracture, single; with manipulation, each bone) for the fracture treatment with manipulation Modifier F2 (Left hand, third digit) appended to 26605 to indicate laterality 26600 (Closed treatment of metacarpal fracture, single; without manipulation, each bone) for the fracture treatment without manipulation Modifier F1 (Left hand...

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