ED Coding and Reimbursement Alert

Question:A 4-year-old girl reports to the ED with her mother; the mother says the child slipped on the porch steps and injured her right wrist the previous day. The mother says that she noticed some swelling when the injury occurred, and the child seemed to be in significant pain due to the injury. The next morning, the mother noticed that the child was still not using her arm normally. Physical exam notes indicate that the patient was alert, and her wrist was swollen and tender. After a level-four ED E/M, the physician orders a two-view wrist x-ray, which shows a displaced fracture of the distal radius; final diagnosis of the injury is Colles fracture. The physician performs a hematoma block and reduces the fracture, then places the patient's wrist in a short-arm cast, immobilizes the wrist and tells the mother to schedule follow-up visits with the orthopedist in three to [...]