Closed treatment of fracture without manipulation

[lmcreynolds@aoamail.net]

What criteria has to be met to be able to charge for a closed treatment of a fracture without manipulation? What constitutes treatment? Does the provider always have to stabilize the bone using a medical supply to justify the charge? Or would a plan for follow up care be enough to justify the charge? Does anyone have a check-list they go by when charging for this? Thanks.

 

[dpaige]

Treatment of a closed fracture without manipulation usually is done with just placement of a cast or splint. Confirmation of the (usually) nondisplaced fracture is confirmed by x-ray and documented in the exam or record. There really isn't a requirement of what constitutes this type of fracture care other than confirming that there is a fracture and deciding to open a 90 day global period by using a nonmanipulative fracture CPT code. I can't imagine a scenario with a fresh fracture that wouldn't require some kind of stabilization, other than maybe a toe fracture that only required buddy taping and maybe a cast or post op shoe. Hope this info helps. (P.S. I need to update my signature, I am no longer chapter president!)

 

[podcoder70]

There is a good article in the Knowledge Center entitled "Don't Break Your Fracture Care Revenue Cycle" that provides valuable information regarding closed treatment of fractures. Here is the link, hope it works.

https://www.aapc.com/blog/41562-dont-break-your-fracture-care-revenue-cycle/#:~:text=Closed%20Treatment%20Always%20Involves%20a%20Medical%20Supply&text=When%20there%20is%20no%20manipulation,of%20support%20for%20weight%20bearing.