• If this is your first visit, be sure to check out the FAQ & read the forum rules. To view all forums, post or create a new thread, you must be an AAPC Member. If you are a member and have already registered for member area and forum access, you can log in by clicking here. If you've forgotten the password it can be reset on our sign in section by entering your registered Email Address or Username here. To start viewing messages, select the forum that you want to visit from the selection below..

Closed tx of phalangeal fx

Krzysztof

Contributor
Messages
24
Location
Matthews, NC
Good Day,

I am seeking your feedback on the proper use of CPT code 28510 (Closed treatment of fracture, phalanx or phalanges, other than great toe; without manipulation, each).

The lay description further describes this procedure: "The physician treats a fracture of one of the four toes other than the big toe. No open surgery or manipulation of the toe or foot is required. X-rays (reported separately) of the toe confirm a fracture or fractures of the bones where the fragments are in an acceptable position. The physician applies a splint, brace, or cast to the toe and foot."

Now, in the case of an encounter during which the pt is dx'd w/ phalangeal fx (confirmed via x-ray), but in the absence of supportive device application, is this code appropriate? One colleague argues that the encounter should be coded as E/M + rad, at most... whereas another colleague argues that the mention of "splint, brace, or cast" application in the lay description does not set a requirement... therefore making CPT code 28510 appropriate.

Thanks in advance!
 
toe fx

According to Coding Companion 2009 by Ingenix Ortho-lower hips and below page 438:
28510-28515
"In 28510, separately reportable x-rays of the toe confirm a fracture or fractures of the bones where the fragments are in an acceptable position. The physician applies a splint, brace, or cast to the toe and foot."

Coding tips:
This procedure may be reported multiple times as it is reported for each closed treatment of a phalangeal fracture performed.

I take this to mean that there must be some treatment, other than buddy taping required. (cast, splint, or brace)

My opinion!!
 
It's nice we all see the same type issues...

It is being argued that "buddy taping" of a toe equals a brace and "every ortho (doc)knows that." I need back up in black and white as to the validity of that. I tend to think not since there is a code for taping/strapping (29550). Can anyone help prove me right? Even wrong, I don't mind!
 
Top