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ED Coding and Reimbursement Alert

Coding 'Comfort' Visits as Fracture Care Can Land ED in Hot Water

Published on Fri Jun 12, 2009

Specialist-caliber broken bone care elevates treatment to procedure status. A patient reports to the ED with a broken bone. The ED physician treats her and sends her home. This is automatically a fracture care claim & right? Wrong: Even if the physician confirms a fracture, this does not guarantee you can choose a fracture care code. Read on to find out when to code for an E/M instead of fracture care, and which modifier to use when your physician provides both services during the same encounter. Report E/M for Comforting Encounters One of the top patient problems in the ED is broken bones, confirmed Raemarie Jimenez, CPC, CANPC, CRHC, during her presentation on ED auditing at the recent AAPC national conference in Las Vegas. So coders need to know all they can about fracture care. When examining a claim, Jimenez recommends that the coder ask herself: Did the physician treat [...]
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