A very common scenario in my practice are patients being referred to me by the Urgent Care facility down the block or the ER near my office. These entities are billing for the fracture care (e.g. 28470 Met fx reduction w/o manipulation). When I try and bill for the same code, Medicare and other payers reject my claim. What am I supposed to do?
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If someone else billed for major global 90 day care, fracture care, you can't bill fracture care. The good news is if all you are doing is now managing them in the global. If your TIN/NPI were unrelated, then you bill the best relevant E/M for the care each visit. Additionally, Medicare allows the add-on code to E/M for situations where you are not the surgeon but are involved in the post-operative care within the global period is HCPCS Code G0559.