25 vs 57 modifier

Our office has always used the 25 modifier when our Ortho performs fx care on the same day as a visit (pt came in with "wrist pain" and was found to have a fx of the radius after x-rays were taken). Now some coders are questioning whether or not this is appropriate because there is a 90 global period. Should they be appending the 57 modifier instead? I still believe it should be a 25 because it's performed immediately at the time of the visit.

Any feedback is appreciated.

Thanks.

Dawn K
breethe3@gmail.com

re: 25 vs 57 modifier

A procedure with a 90 day post op is considered major surgery. Modifier 25 applies when a minor procedure is done.

re: 25 vs 57 modifier

This is payer specific but in my experience most payers prefer the 57 modifier since fracture care has a 90 day global.