ED Coding and Reimbursement Alert
Don't Misstep When Dealing with Tarsal Fractures
Question: We had a patient present with a non-displaced tarsal bone fracture, which did not require manipulation. Instead of applying a cast, the physician placed a prefabricated short leg removable cast. The patient will not require much in the way of additional treatment, but was instructed to follow up with the orthopedist in two weeks. Can this be reported as fracture care?
Wisconsin Subscriber
Answer: Yes, if documented appropriately you would report one code for this patient — 28450 (Treatment of tarsal bone fracture [except talus and calcaneus]; without manipulation, each). In this case, the physician has determined that there is a fracture and decided on the appropriate course of treatment, so he is meeting the requirements for reporting the fracture care code. However, unless he is providing the associated follow-up fracture care included in the global surgical package, be sure to append the 54 modifier to indicate you are reporting the procedure only.
ED Coding and Reimbursement Alert
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