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Podiatry Coding & Billing Alert

Fracture Care Coding:

29550 or 28490? Find the Right Fracture Code for the Case

Published on Mon Sep 24, 2012

You could be missing more than $100 in deserved reimbursement.How can you tell if a claim merits a fracture care code or an E/M code? It's usually hard to tell right away as experts agree that code selection will likely depend on a case-to-case basis. Take the following four factors into account to find the best fit the fracture treatment.1. Match Fracture Treatment With CriteriaYou'd know you should report fracture care, if the scenario meets the following criteria:The physician sees the patient for her initial visit for the injury (e.g., 826.x, Fracture of one or more phalanges of foot, and 838.xx, Dislocation of foot). The injury is recent enough that it has not already healed on its own.The patient has not had surgery for this injury by another physician in a different practice. (For instance, if the patient was injured while on vacation, had surgery and now is home and [...]
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