Podiatry Coding & Billing Alert

Question: A patient was treated for a fracture of the second metatarsal. Four weeks later, an X-ray revealed that the fracture had failed to heal at all. How should I code for the condition of non-healing metatarsal? California Subscriber Answer: A delayed union is the failure of a bone to heal. For the first visit, use 825.25 (Fracture of other tarsal and metatarsal bones, closed; metatarsal bone[s]) and 28470 (Closed treatment of metatarsal fracture; without manipulation, each). For the second visit, the diagnosis would be 733.82 (Nonunion of fracture) with late-effects code 905.4 (Late effect of fracture of lower extremities) as a secondary diagnosis. Be aware that if you bill fracture treatment code 28470 to Medicare, you have put the doctor into a 90-day global, preventing you from billing any more visits for that time period. Your other option is to bill the patient's first visit as an office visit, which [...]