Wiki Closed Fracture

[richelle25]

Hello,
Our office recently joined a larger group and our providers are being told if they have a closed non- manipulative fracture, that they do not use a medical supply (splint, dme, etc) to stabilize the fracture they can not bill for the closed fracture. I have been researching this and I found an article from AAPC stating "If the provider does not stabilize the bone using a medial supply, or does not indicate a plan for follow- up care" the fracture can not be billed. My question is, what is considered plan for follow up care? Any suggestions?

 

[lburgos31]

Hello,

A plan for follow up care would be a post op visit after initially treating the fracture by either closed or open treatment. Closed treatment would need to document some sort of manipulation and/or immobilzation such as a boot/sling/cast/splint. The follow up care would be considered post op and would be included in the payment for fracture care. So an E/m would not be billed for follow up care. If the patient needed to be recasted for some reason that can be billable.

Hope that helps.

Linette Burgos, COSC