Wiki Fracture care without fracture diagnosis

fltbaroque

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Frequently, our providers will charge fracture care when there is "no definitive fracture seen" or "possible fracture". They may send the patient for an MRI to verify the fracture. Am I correct in assuming that fracture care should NOT be charged unless they are SURE it's a fracture??
Also, if the patient is sent for an MRI and they do indeed have a fracture, can I charge for fracture care on the MRI followup visit?

Any input would be appreciated.

Thanks!
Tobi C.
 
What diagnosis are you linking to the fracture care?

If your physician "suspects" or does not see a fracture, I would not bill fracture care. What diagnosis could you link to it? Are you billing fracture care with a fracture diagnosis that is only "suspected"? If so that would be wrong.

Personally I would not bill for fracture care unless you know that there is a fracture. I understand that a fracture may be difficult to see at first since there is no re-growth line.

I would also look at this from an auditing point of view. If you are billing for treating a fracture when no fracture is identified, your doctors could be paying back a large sum of money with fines added to it.

The physician can initiate fracture care at any time, but since it has a 90 day global, the sooner the better. But there better be a fracture.
 
If your physician "suspects" or does not see a fracture, I would not bill fracture care. What diagnosis could you link to it? Are you billing fracture care with a fracture diagnosis that is only "suspected"? If so that would be wrong.

Personally I would not bill for fracture care unless you know that there is a fracture. I understand that a fracture may be difficult to see at first since there is no re-growth line.

I would also look at this from an auditing point of view. If you are billing for treating a fracture when no fracture is identified, your doctors could be paying back a large sum of money with fines added to it.

The physician can initiate fracture care at any time, but since it has a 90 day global, the sooner the better. But there better be a fracture.

That's the way I felt about it, too. Thanks for your input!
 
fracture care without fracture

The way I understand it, fracture care is ongoing management of the fracture (to make sure it is healing properly) during the global period once a treatment has been performed. But still, there has to be a fracture, not a suspected or possible one, only to be proven wrong by the x-rays or MRI.
 
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