External Fixator in the OR

Reenie98

Contributor
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20
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Columbus, Ohi
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Hello!
We have a physician; who is using an external fixator in the OR. It is being applied to reduce the fracture so the physician can apply the internal fixation without an extra set of hands in the extremity. It is then removed and casted and/or braced following surgery. I don't think this is billable; as it is not really being used in the manner an external fixator is devised for; but we have another coder who disagrees.

Do any of you have experience with this? Can you point me in the direction of some documentation. I have come up empty handed at this point.

Thanks in advances for time and assistance!
 

jjhamer1

Guru
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McMinnville, OR
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Put this thru the Encoder just for grins:

25515 - Open treatment of radial shaft fracture, includes internal fixation, when performed
20690 - Application of a uniplane, unilateral, external fixation system

Did not get any edits for this test!
 

Reenie98

Contributor
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Columbus, Ohi
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That makes sense; because you can bill for an ORIF; and an External Fixator. But the External Fixator is part of the treatment at that point and has a 90 day global period.

Sometimes things do not bundle; but you know you should not bill them (IE scouting scopes).

Should we really be billing for an External Fixator used in the OR? It is placed and removed in the same session; and is used to hold bones in place while applying ORIF. It seems strange to me to bill for something that has a 90 day global; but we only used it for an hour? I just want to make sure we are not overbilling in this situation.
 
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