So from your logic the metacarpals are not fingers, from my logic you use the F modifiers for the metacarpals as there are 5 in each hand that correspond to each finger. This was described originally in the fracture of the metacarpal bone of the little (small) finger because this is the most common one to break when punching an immovable object. A boxer's fracture involves a break in the neck of the metacarpal. The head of the metacarpal bones form the knuckle of an enclosed fist. The head of the metacarpal bone connects the metacarpal bone to the bone of the finger. The neck is the portion of the bone that connects the shaft to the head. The shaft is the long, slender portion of the bone. The base of the metacarpal bone is the portion that attaches to the bones of the wrist. Each consists of the base, the shaft, the neck, and the head. All of the metacarpal bones have the same anatomic structure. There are 5 metacarpal bones-1 to connect each finger to the wrist. The metacarpal bones in the hand connect the bones in the finger to the bones in the wrist. You are using the F in the modifier to mean literally finger and not the entire bone This from the hand book: I also took my my CPC exam last August and passed.I think the issue is the use of the word finger. If you are using multiple modifiers to describe the procedure performed also add modifier 99 so the payer is aware of there being more than one modifier.įYI.I am a Medical Coding/Billing//Health Information Technology student so trying to help you out with this is good practice for me. Repair and reattachment of peroneus brevis tendon left - code 28200. Open reduction, internal fixation 5th metatarsal base fracture left foot - code 28485. Adding the additional codes like the external cause and the factors influencing health status and contact with health services codes are needed to further support the procedure code and the modifiers given. Hoping someone can help me with the coding for the interpositional arthroplasty of the 4th and 5th TMTJ. There is no definitive literature that describes the exact amount of translation and angulation that is acceptable for metatarsal neck and shaft fractures. You shouldn't have to change anything with what was previously coded like the dx and cpt codes should stay the same. Fifth metatarsal neck and shaft fractures may be treated with a variety of nonoperative modalities and weightbearing as tolerated 19. If I am missing anything here hopefully someone else will come on this thread and add to it but I feel like I covered most if not all what needs to be coded. The code for this is Z91.19 "Patient's noncompliance with other medical treatment and regimen". The final code I feel is needed is one that indicates the patient not adhering to your instructions following surgery. I'm not sure how this encounter would fit the diagnosis considering the circumstances. Do you know anything else about the fall so the code has more specificity as to what caused the fall? If it is not known then I would say the fall was accidental in nature and is not further specified, W19.XXXA if this is the initial encounter, W19.XXXD for subsequent encounter or W19.XXXS if it is a sequela. Your dx code for this would be what was used on the initial claim and the external cause code is the fall. You have to also use any external cause codes which would be the cause of the injury, which would be the fall. The diagnosis codes I know have to relate to the procedure code. The modifiers you would need are for laterality (RT or LT) and a couple of other modifiers I don't know which would be correct but I am thinking if you would describe this as an "increase in procedural services" then you would need modifier 22 and since this sounds like a "repeated procedure or service by same physician or other qualified healthcare professional" you would use modifier 76. I was thinking modifier 78 as well but part of the description for when to use this modifier says within the "postoperative period" which is 10 days and the patient didn't return until after 2 weeks post surgery (14-days). Was the procedure open or closed treatment? If you didn't specify open or closed treatment in the procedure note and just specified that it was a nonunion repair of the 5th metatarsal base of the left or right foot then your code would be 28322 with the proper modifiers for laterality in addition to either modifiers 22 and/or 76.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |