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ED Coding and Reimbursement Alert

Reader Question:

Strapping the Shoulder

Published on Thu Nov 01, 2001

Question: A patient arrived at our ED with a shoulder fracture. The ED attending applied an immobilization (strapping) and referred the patient to ortho-pedics for definitive treatment and follow-up. How should I code this?

Georgia Subscriber  
Answer: The ED coder should report the immobilization with 29240 (strapping; shoulder [e.g., Velpeau]). In addition to the strapping code, if a separate service (determining the existence of a fracture and the exam involved) was provided beyond the strapping, that service would be reported using the appropriate ED E/M code (99281-99285) with modifier -25 (significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service) attached to the E/M code.
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