dwilleycpc
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Is it correct coding to Code for a E&M when billing for Fracture Care? I have a Ortho Doctor that will bill a E&M with the DX for 729.5 when a Fracture is billed.
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Wiki E&M With Fracture Care
- Thread starter dwilleycpc
- Start date
RebeccaWoodward*
True Blue
Typically, you can bill an E/M with fracture care if:
1. The E/M occurs on the same day of or the day before the surgical procedure.
2. The E/M service directly prompted the surgeon's decision to perform surgery. (Modifier 57-Decision for surgery)
3. The surgical procedure following the E/M has a 90-day global period. In your case, fracture care.
Normally, you don't need a different DX (in your case-729.5) for the E/M to be paid but some carriers can be problematic. (Appeal in this case).
1. The E/M occurs on the same day of or the day before the surgical procedure.
2. The E/M service directly prompted the surgeon's decision to perform surgery. (Modifier 57-Decision for surgery)
3. The surgical procedure following the E/M has a 90-day global period. In your case, fracture care.
Normally, you don't need a different DX (in your case-729.5) for the E/M to be paid but some carriers can be problematic. (Appeal in this case).