ED Coding and Reimbursement Alert

Sprained, bruised, broken ... avoid denials by finding out exact injury. When a patient reports to the ED with a broken toe and the ED physician "buddy tapes" it to another toe for stabilization, reporting a fracture care code vs. a strapping code is an important consideration -- it might make a difference of $95 per encounter. Look out for payer discrepancies, however, as there is no golden rule for coding this type of toe-taping. Spot Definitive Care, or Forget Fracture Code If the physician provides restorative/definitive care for the patient's broken toe, the service could be fracture care. "Buddy taping is often the definitive treatment for this type of injury," explains Robert LaFleur, MD, FACEP, of Medical Management Specialists in Grand Rapids, Mich. In some cases, the following actions can also represent definitive care for broken toes: • ice • pain medication prescription • discharge instructions. Example: A patient reports [...]