Wiki fracture care - closed treatment

lolson

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Is placement of a cast, splint or brace required in order for a provider to bill fracture care codes 28450 & 28470?
We have a situation where a provider is billing these codes simply because he diagnosed the fractures from an MRI. He recommended 'closed treatment' but did nothing to actually treat the fracture. Is it appropriate for the provider to bill for CPT codes 28450 & 28470 in this situation?
 
No. IF UCC applies cast or splint for stability then refers the patient out to specialist 7-10 days out then use stabilization codes. 29000-29050.

If UCC assume responsibility for the fracture then use fracture care codes. It doesn't sound like your doctor is assuming responsibility for the fracture.

I hope this helps

Lisa Johnson, CPC
 
Thanks for your reply. One more question. . . what does UCC mean?
The physician referred to in my question is a specialist and is assuming follow up for fracture care. So, I am just wondering if those fracture care codes 28450 & 28470 require placement of some stablizing device.
 
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