Part B Coding Coach: Fracture Care Spans Multiple Providers? Try These Modifiers

Why This Topic Matters

Split fracture care is a common source of claim errors, denials, and payer audits. Understanding the relevant billing structure helps practices report services consistently when care is shared across providers.

Article Sections

1. Modifier 54 and fracture care with 90-day globals

   Introduces billing for the portion of fracture care associated with the initial surgical service and discusses when this modifier category is considered in relation to global periods.

2. Example involving emergency department fracture care

   Presents a clinical billing scenario involving fracture treatment and payment considerations for the provider performing the initial portion of care.

3. Modifier 55 and postoperative follow-up care

   Explains reporting for the postoperative portion of fracture care when another provider handled the initial treatment and the global service is shared.

4. Example involving follow-up orthopedist care

   Provides a second fracture-care scenario showing how postoperative management is coordinated after the initial procedure.