Orthopedic Coding Alert

Question: What are the guidelines for coding fracture care, as opposed to cast application and subsequent visits? An example would be closed fracture of radius that did not require manipulation.

ORC subscriber, Austin, TX

Answer: Fracture treatment without manipulation is defined as the application of a cast, splint, bandage or other traction/immobilization/stabilization device without doing a reduction. If the physician applies the original cast or other device, and assumes all of the subsequent care, use the code for fracture care without manipulation (25560 or 25600 - radial). Removal of the device is included in the application. If casting or immobilization is done by a physician who will not be giving any subsequent treatment, that physician may use a casting or strapping code and/or supply code in addition to the appropriate E/M services code -- depending on the individual situation.

Note: There are too many casting and strapping codes to list here (29000-29799). Use the procedure and supply codes that best describe the services provided and supplies used you applied.